中药脐透消臌贴膏敷脐治疗肝硬化门静脉高压疗效观察

作者	单位
施维群	浙江中医药大学附属第二医院肝病中心
茹清静	浙江中医药大学附属第二医院肝病中心
蔡国英	浙江中医药大学附属第二医院肝病中心
倪伟	浙江中医药大学附属第二医院肝病中心

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中文摘要:

目的观察自制中药脐透消臌贴膏对肝硬化门静脉系统血流动力学的影响。方法120例肝硬化门脉高压患者分为两组,在常规治疗基础上,治疗组(66例)于脐部敷脐透消臌贴膏,每3天更换1次,期间休息1天;对照组(54例)口服心得安,两组疗程均为1个月。治疗前后采用彩色多普勒超声仪观察门、脾静脉血流动力学变化,并观察肝功能、凝血功能及自觉症状等。结果两组经治疗后,门静脉及脾静脉内径显著缩小、门静脉及脾静脉的血流速度明显加快(P<0.05),门静脉血流量明显下降(P<0.05);但脾静脉的血流量均无显著改变(P>0.05)。两组肝功能及凝血指标均有改善;临床症状改善以治疗组为优。结论中药脐透消臌贴膏脐部贴敷治疗,能在短期内降低肝硬化门静脉压力,疗效与心得安相当,且无不良反应。

英文摘要:

Objective To observe the effect of umbilical sticking therapy(UST) with Qitou Xiaogu Plaster(QXP) on hemodynamics of portal system in patients with liver cirrhosis.Methods One hundred and twenty patients of liver cirrhosis with portal hypertension were assigned to two groups.On the basis of conventional therapy,UST was applied in the 66 patients in treated group,which was exchanged once every 3 days with an interval of 1-day rest.The 54 patients in the control group were orally administered with propanolol.The therapeutic course for both groups was 1 month.Before and after treatment,the hemodynamic changes in portal or splenic veins were observed by color Doppler ultrasonograph,and the changes of liver function,blood coagulation and patients’ subjective symptoms were observed as well.Results After treatment,portal vein diameter and splenic vein diameter significantly decreased(P<0.05),portal venous flow velocity and splenic venous flow velocity apparently increased(P<0.05),and portal venous flow apparently decreased in both groups(P<0.05),while no significant change was found in the splenic venous flow(P>0.05).The liver function and blood coagulation indexes in both groups were improved.The improvement of clinical symptoms in the treated group was superior to that in the control group.Conclusion UST with QXP could decrease the portal vein pressure in a short time,with the therapeutic effect comparable to propanolol,and with no adverse reaction.

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