The potential benefit managing ascites due to cirrhosis using an integrative medicine approach
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摘要:
腹水是肝硬化失代偿期的常见表现,反复大量的腹水严重影响患者生活质量及预后,常需要中西医结合综合治疗。本文首先介绍了肝硬化腹水的病因、利尿与补充白蛋白等常规治疗,继之介绍了抗感染、利水剂、血管活性药物等在难治性腹水中的应用,中医药辨证分型与特色治疗,中药巴布剂敷脐与腹水浓缩回输等的外治法。临床实践中需根据病情合理选择治疗方法,以提高疗效,减少复发。
Abstract:While ascites are the most common complication of cirrhosis, and can be easily upon first appearance managed by simple clinical (i.e.diuretics) and behavioral (i.e.low-salt diet) interventions, the persistent cirrhotic state and treatment resistance makes recurrent ascites a long-term challenge to the patient's quality of life and prognosis.Such "refractory" ascites due to cirrhosis have been associated with increased risk of intra-abdominal infections, kidney failure, and progressive cirrhosis.The shortcomings of Western medicine to appropriately manage ascites due to cirrhosis has led to a research interest in whether an integrated approach with traditional Chinese medicine (TCM) will benefit these patients.In this article, we summarize the current reports and outcomes of integrated approaches to treat ascites due to cirrhosis.Specifically, we first discuss the pathophysiological process of the disease.The standard Western treatments and their mechanisms, including the various modulated strategies that have been designed according to the putative etiologies of refractory ascites, such as delivery of antibiotics and vasoactives, are then introduced.Finally, the patterns of Qi associated with refractory ascites and cirrhosis are detailed, along with the various promising TCM-specific applications to address each.The use of a Western medicine and TCM integrative approach for managing refractory ascites due to cirrhosis should continue to be researched and developed.
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Key words:
- liver cirrhosis /
- ascites /
- TCM WM THERAPY
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