养血柔肝方治疗肝硬化代偿期门静脉高压症的临床研究

发布时间：2018-02-16 02:14

本文关键词： 养血柔肝方肝硬化代偿期门脉高压症临床研究　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察养血柔肝方治疗肝硬化代偿期门脉高压症患者的临床疗效,并与盐酸普萘洛尔片对照组相比较,评价养血柔肝方对肝硬化代偿期门脉高压症的治疗效果。方法:选择住院治疗的符合肝硬化代偿期门静脉高压症诊断标准的患者60例,按随机对照原则分为治疗组(30例)和对照组(30例),对照组予盐酸普萘洛尔片剂,治疗组予养血柔肝方,两组疗程均为3个月。在治疗前后分别观察患者的临床症状、体征、肝功能、血清肝纤维化指标、肝脏硬度值、食管胃底静脉曲张程度、门静脉内径(Diameter of portal vein,Dpv)、门静脉血流速度(Velocity of portal vein,Vpv)的变化,比较两组患者的疗效。结果:(1)两组患者治疗后临床症状、体征均有不同程度改善,中医症候总积分值下降。治疗组疗效明显优于对照组,组间比较差距有统计学意义。(P0.05)。(2)两组病例治疗后肝功能指标ALT,TBIL,ALB均有不同程度的好转。两组病例治疗后ALT,TBIL下降水平差异显著,组间比较有统计学意义(P0.05)。治疗后两组ALB均升高,但两组之间的差异无统计学意义(P0.05)。(3)两组治疗后血清肝纤维化指标HA,PCⅢ,IV-C,LN均有不同程度下降,治疗组治疗前后差异有显著性(P0.05),对照组治疗前后比较差异无显著性(P0.05)。两组治疗后比较(P0.05),差异有统计学意义。(4)两组治疗后肝脏硬度值下降,治疗组治疗前后差异有统计学意义(P0.05),对照组治疗前后比较差异无显著性(P0.05)。两组治疗后比较(P0.05),差异有统计学意义。(5)两组治疗后食管胃底静脉曲张程度均有减轻,治疗组与对照组比较(P0.05),差异具有统计学意义。(6)治疗组服用养血柔肝方3个月后门静脉内径、血流量与治疗前比较差异具有显著性(P0.05),血流速度治疗后与对照组比较差异无显著性(P0.05)。结论:养血柔肝方能有效改善肝硬化代偿期门脉高压症患者的临床症状及体征,改善肝功能,降低血清肝纤维化指标,减轻食管胃底静脉曲张程度,能够使患者门静脉内径回缩及门静脉血流量较前下降。其作用机制体现了养血柔肝方的“柔肝软坚”功效,具体疗效机制有待于进一步明确。
[Abstract]:Objective: to observe the clinical effect of Yangxuelugan recipe in treating patients with compensatory portal hypertension of liver cirrhosis, and compare with the control group of propranolol hydrochloride. Objective: to evaluate the therapeutic effect of Yangxuelugan recipe on compensatory portal hypertension in cirrhotic patients. Methods: sixty patients with compensatory portal hypertension of liver cirrhosis were selected for inpatient treatment. According to the principle of random control, they were divided into treatment group (n = 30) and control group (n = 30). The control group was given propranolol hydrochloride tablet and the treatment group was given Yangxue Rugan recipe for 3 months. The clinical symptoms and signs of the patients were observed before and after treatment. Changes of liver function, serum hepatic fibrosis index, liver hardness, degree of esophageal and gastric varices, diameter of portal vein diameter of portal veinDpvn, portal vein velocity of portal velocities in VPV). Results after treatment, the clinical symptoms and signs of the two groups were improved to some extent, and the total integral value of TCM symptoms decreased. The curative effect of the treatment group was significantly better than that of the control group. The difference between the two groups was statistically significant (P < 0.05).) after treatment, the liver function index (alt) TBIL-ALB of the two groups were improved to some extent, the level of alt TBIL decreased significantly after treatment, and there was significant difference between the two groups (P 0.05). After treatment, the ALB of the two groups were all increased. But there was no significant difference between the two groups. There was significant difference before and after treatment in the treatment group, but there was no significant difference between the control group and the control group before and after treatment. After treatment, there was a significant difference between the two groups (P 0.05), the difference was statistically significant (P < 0.05). There was significant difference before and after treatment in the treatment group (P 0.05), but there was no significant difference between the control group (P 0.05) and the control group (P 0.05). After treatment, there was a significant difference between the two groups (P 0.05) the degree of esophageal and gastric fundus varices in the two groups was reduced after treatment, and there was no significant difference between the two groups before and after treatment. The difference between the treatment group and the control group was statistically significant. The blood flow was significantly different from that before treatment (P 0.05), but there was no significant difference between the blood flow velocity after treatment and the control group. Conclusion: Yangxue Rugan recipe can effectively improve the clinical symptoms and signs of patients with compensatory portal hypertension of liver cirrhosis. Improving liver function, reducing serum hepatic fibrosis index, reducing the degree of esophageal and gastric varices, can make portal vein internal diameter shrink and portal vein blood flow lower than before. The mechanism of curative effect needs to be further clarified.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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