目的:观察利水消癥汤治疗脾肾阳虚型肝硬化腹水患者的临床疗效.方法:将110例肝硬化腹水患者,随机分为2组,每组各55例.对照组患者给予常规西药治疗,观察组患者在对照组治疗的基础上给予利水消癥汤治疗,每日1剂,两组14天为1疗程,连续治疗2疗程.观察治疗前后两组患者肝功能指标、基本临床特征、影像学指标;比较两组患者临床症状消失时间和临床疗效.结果:治疗后两组患者ALT、TBIL、AST、VEGF及ET-1较治疗前显著降低(P＜0.05),ALB则较治疗前显著升高(P＜0.05),观察组较对照组变化幅度显著(P＜0.05);治疗后两组患者的腹围及体质量明显降低,24小时尿量显著增多,并且观察组较对照组改善显著,两组比较有统计学意义(P＜0.05);治疗后观察组的腹水深度、门静脉、脾静脉主干内径及脾脏厚度改善程度较对照组明显,两组比较有统计学意义(P＜0.05).观察组患者各项临床分级评分显著低于对照组(P＜0.05);观察组患者的临床症状消退时间明显少于对照组,两组比较有统计学意义(P＜0.05).观察组的临床总有效率显著高于对照组,两组比较有统计学意义(P＜0.05).结论:利水消癥汤治疗脾肾阳虚型肝硬化腹水临床疗效确切,值得临床推广使用.“,”Objective:To observe the clinical efficacy of Lishui Xiaozheng Decoction in treating cirrhosis and ascites due to deficiency of spleen and kidney.Methods:110 patients with ascites due to cirrhosis were randomly divided into 2 groups, 55 cases in each group.The patients in the controlled group were treated with conventional western medicine.The patients in the observation group were treated with Lishui Xiaozheng Decoction on the basis of the controlled group, 1 doses per day, two groups of 14 d as 1 courses, and continuous treatment for 2 courses of treatment.The liver function indexes, basic clinical characteristics and imaging indexes of the two groups were observed before and after treatment.The clinical symptoms disappeared time and clinical efficacy of the two groups were compared.Results:After treatment, ALT, TBIL, AST, VEGF and ET-1 were significantly lower than before treatment (P ＜ 0.05), ALB was significantly higher than before treatment (P ＜ 0.05), and the change of the observation group was significantly higher than that of the controlled group (P ＜ 0.05).The abdominal circumference and body mass of the two groups were significantly lower, and the 24 h urine volume increased significantly after the treatment, and the observation was observed in the two groups.Compared with the controlled group, the improvement of the two groups was statistically significant (P ＜ 0.05).The improvement of the ascites depth, the portal vein, the main trunk diameter of the splenic vein and the thickness of the spleen in the observation group after treatment was significant compared with the controlled group, and the two groups were statistically significant (P ＜ 0.05).The clinical grading scores of the patients in the observation group were significantly lower than those in the controlled group (P ＜ 0.05), and the clinical symptom subsiding time of the observation group was significantly less than that of the controlled group, and the two groups were statistically significant (P ＜ 0.05).The total effective rate of the observation group was significantly higher than that of the controlled group, and the two groups had statistical significance (P ＜ 0.05).Conclusion:Lishui Xiaozheng Decoction is effective in treating cirrhosis and ascites due to deficiency of Spleen Yang and kidney Yang, and is worthy of clinical application.