益气解毒通络方治疗肝硬化门静脉高压症的疗效观察

发布时间：2018-04-08 17:22

本文选题：肝硬化门静脉高压症　切入点：益气　出处：《北京中医药大学》2017年硕士论文

【摘要】：目的:本课题主要目的是观察益气解毒通络方治疗肝硬化门静脉高压症的临床疗效,通过比较治疗前后肝硬化门静脉高压症患者的症状/体征、凝血功能、肝功能、腹部超声等变化来探讨和验证本治疗方案的临床有效性和实用性,同时观察临床使用中的不良反应以评价其安全性,发挥中医药的特点和优势,为肝硬化门静脉高压症的临床治疗提供新思路。方法:研究对象均为北京中医药大学东直门医院肝炎门诊就诊的患者,且符合本课题的入选标准,共34例。34例研究对象均服用益气解毒通络方治疗6个月,记录、观察、比较治疗前后研究对象的中医症候积分、凝血功能、肝功能及门静脉内径、脾静脉内径等变化情况,使用SPSS21.0计算机统计分析软件对统计数据进行统计分析。结果:(1)治疗后患者的胁肋疼痛、纳呆食少、倦怠乏力、脘腹胀满症状和胁下痞块、肝病面容较治疗前明显减轻(P0.01),出血症状(P0.05)较治疗前减轻,但赤丝红缕体征在治疗前后无明显变化(P0.05)。(2)血凝PT、PTA指标在治疗3个月与治疗6个月较治疗前均有明显改善(P0.01),说明此方案在改善凝血功能方面起到作用。治疗6个月的数据与治疗第3个月数据比较,凝血功能获得进一步改善(P0.01)。(3)治疗3个月、治疗6个月后患者的ALT、AST、ALB、TBIL、GGT均有改善(P0.01),证明此治疗方案在改善肝功能方面效果显著。治疗6个月的数据与治疗第3个月数据比较,肝功能获得进一步改善(P0.01)。(4)治疗后肝脏超声下门静脉主干内径、脾静脉内径、脾脏长度、脾脏厚度均有改善,差异具有非常显著的统计学意义(P0.01),说明本方案对于降低门静脉压力方面有较好的疗效。(5)主要不良事件:个别患者在治疗过程中出现了多梦、大便次数增多、皮疹症状,后均自行缓解,未再出现特殊不适。结论:(1)益气解毒通络方可以改善症状/体征、凝血功能、肝功能、腹部彩色多普勒超声的检测指标,说明益气解毒通络方治疗肝硬化门静脉高压症具有临床效果。(2)肝硬化门静脉高压症患者的病情会随着时间推移逐渐加重,需要长期坚持正确的治疗方案进行治疗,对于益气解毒通络方治疗效果的长期疗效也需要进行长期的随访。
[Abstract]:Objective: to observe the clinical effect of Yiqi jiedu Tongluo recipe in treating cirrhotic portal hypertension and compare the symptoms / signs, coagulation function and liver function before and after treatment.The changes of abdominal ultrasound were used to explore and verify the clinical effectiveness and practicability of this treatment, and to observe the adverse reactions in clinical use to evaluate its safety, and to give full play to the characteristics and advantages of traditional Chinese medicine.To provide a new idea for the clinical treatment of cirrhotic portal hypertension.Methods: the subjects were all the patients with hepatitis in Dongzhimen Hospital of Beijing University of traditional Chinese Medicine, and according with the selection criteria of this study, 34 patients were treated with Yiqi jiedu Tongluo decoction for 6 months, recorded and observed.The changes of TCM symptom score, coagulation function, liver function, portal vein diameter and splenic vein diameter were compared before and after treatment. The statistical data were analyzed by SPSS21.0 software.Results (1) after treatment, the patients suffered from pain in the rib, less food intake, fatigue, abdominal distension and hypochondriac bulge. The face of liver disease was significantly reduced than that before treatment, and the symptoms of hemorrhage were alleviated than that before treatment (P0.05).However, there was no significant change in P0.05 P0.05. 2) the blood coagulation PTT PTA index was significantly improved in 3 months and 6 months after treatment compared with that before treatment, indicating that this scheme plays an important role in improving coagulation function.Compared with the data of the 3rd month, the coagulation function was further improved for 3 months. After 6 months of treatment, the patients with ALT AST and TBILG GT all improved P0.01G GT, which proved that the treatment regimen was effective in improving liver function.Compared with the data of the 3rd month after treatment, the liver function was further improved (P0.01U. 4) after the treatment, the diameter of portal vein, the diameter of splenic vein, the length of spleen and the thickness of spleen were all improved.The difference was statistically significant (P 0.01), indicating that this regimen had a better effect on reducing portal vein pressure.) the main adverse events were: some patients had more dreams, more defecations, and rash symptoms during the course of treatment.After the relief, there was no special discomfort again.Conclusion (1) Yiqi jiedu Tongluo prescription can improve symptoms / signs, coagulation function, liver function, abdominal color Doppler ultrasound detection index.It shows that Yiqi jiedu Tongluo recipe has clinical effect in treating cirrhotic portal hypertension.The long-term effect of Yiqi-jiedu Tongluo prescription also needs long-term follow-up.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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