中西医治疗顽固性肝硬化腹水的研究进展

Research Advances in the Integrated Traditional Chinese and Western Medicine Treatment of Refractory Cirrhotic Ascites

摘要: 肝硬化是一种常见的消化系统疾病，随着肝组织结构的改变和肝功能的逐步减退，患者可出现门静脉高压和低蛋白血症，导致机体内环境紊乱，进而诱发顽固性腹水(refractory ascites, RA)，是肝硬化失代偿期的严重并发症，以高发病率、预后差为特点，其形成机制复杂，涉及多因素共同作用，单纯西医治疗存在利尿剂抵抗、复发率高等局限性，严重影响肝硬化的自然病程，严重威胁患者生命。然而中西医结合可通过多靶点、多途径整体调节，在提高疗效、减少并发症方面可能具有潜在优势。本文系统梳理近年来中西医结合治疗顽固性肝硬化腹水的研究现状，总结其作用机制、有效方案和优势，以期为临床实践提供参考。

Abstract: Cirrhosis is a common digestive system disorder. As the liver structure alters and liver function progressively declines, patients may develop portal hypertension and hypoalbuminemia, leading to internal environment disturbances and subsequently triggering refractory ascites (RA). As a severe complication of the decompensated stage of cirrhosis, it is characterized by high incidence and poor prognosis. Its pathogenesis is complex, involving multiple interacting factors. Sole reliance on Western medicine treatment faces limitations such as diuretic resistance and high recurrence rates, which significantly impact the natural course of cirrhosis and pose a serious threat to patient lives. However, integrated traditional Chinese and Western medicine may offer potential advantages by holistically regulating the body through multi-target and multi-pathway mechanisms, which could lead to improved therapeutic outcomes and reduced complications. This paper systematically reviews the current research status of integrated traditional Chinese and Western medicine in treating refractory cirrhotic ascites in recent years, summarizing its mechanisms of action, effective protocols, and advantages, aiming to provide references for clinical practice.