健脾益气固摄法治疗肾移植术后腹水外渗的初步临床观察

[目的]研究健脾益气固摄法治疗肾移植术后腹水外渗的临床疗效及不良反应。[方法]将14例行肾移植术5 d后肾周引流液仍持续增多的患者,采用随机数字表法按1:1随机分为治疗组及对照组,每组各7例。治疗组除补充白蛋白外, 并予健脾固摄中药(太子参、黄芪、茯苓、白术、淮山、扁豆、神曲、牡蛎)进行治疗,每天两剂,疗程1周;对照组仅予补充白蛋白治疗。以每天引流液量、引流液持续时间和血浆白蛋白、总蛋白含量作为临床疗效评价指标,以急性排斥发生率、肝肾功能指标、环孢素A(CsA)血浓度谷值作为不良反应评价指标。[结果]治疗组的每天引流液量、引流液持续时间与对照组相比明显减少,差异具有非常显著性意义(P<0.01),而两组血浆白蛋白、总蛋白含量无显著性差异(P> 0.05)。两组的急性排斥发生率、肝肾功能指标、CsA血浓度谷值均无显著性差异(P>0.05)。[结论]健脾益气固摄法能有效地减少每天引流液量及缩短引流液持续时间,且无肝肾功能损害及增加急性排斥发生率等不良反应。

Clinical Observation on Spleen-strengthening and Qi-invigorating Therapy in Treating Ascitic Effusion in Patients After Kidney Transplantation

[Objective] To observe the therapeutic effect and adverse effects of spleen-strengthening and Qi-invigorating therapy in treating ascitic effusion in patients after kidney transplantation. [Methods] Fourteen cases still with abundant perirenal drain 5 days after kidney transplantation were randomized into groups A and B. Group A was treated with albumin (Alb) and spleen-strengthening and Qi-invigorating herbal medicine (Sijunzi Decoction modified with Radix Astragali and Concha Ostreae), two doses per day, and group B with albumin alone. The treatment course lasted one week. After treatment, daily drain amount, drainage duration, plasma albumin (Alb) level and total protein (TP) content were observed to evaluate the therapeutic effect; incidence of rejection reaction, hepatic and renal function, and serum valley value of cyclosporin A (CsA) were detected to observe the adverse effects. [Results] Daily drain amount and drainage duration were decreased in group A (P < 0.01) as compared with those in group B. Plasma albumin level and total protein content in group A did not differ from those in group B; the differences of the incidence of rejection reaction, hepatic and renal function, and serum valley value of CsA were insignificant between the two groups ( P > 0.05). [Conclusion] Spleen-strengthening and Qi-invigorating therapy is effective in reducing daily drain amount and drainage duration in patients after kidney transplantation, and has no adverse effects such as damage of hepatic and renal function and increase of incidence of rejection reaction.