加味瓜蒌散治疗肝硬化门静脉高压症临床观察  

Clinical Observation on Modified Gualou Powder for Liver Clrrhosis with Portal Hypertension

作　　者：李民[1] 顾尔莉[1] 章幼奕[1] 王陆军[1] 窦志华[1] 罗琳[2] 徐济良[2] 陈鸣鸣[1] 陈淑范[1] 葛春霞[1] 

机构地区：[1]南通大学附属南通第三医院肝病科,江苏南通226006 [2]南通大学医学院基础医学院,江苏南通226001

出　　处：《新中医》2009年第4期18-20,共3页New Chinese Medicine

基　　金：江苏省南通市社会发展科技计划资助项目(编号:S40019)

摘　　要：目的:观察加味瓜蒌散治疗肝硬化门静脉高压症的临床疗效。方法:选择符合中医血瘀络阻证型肝硬化门静脉高压症患者40例,随机分为2组。2组均常规接受护肝、降酶等对症治疗,治疗组加服加味瓜蒌散,对照组加服普萘洛尔。治疗前后进行临床症状及体征计分,清晨空腹取血放免法测肝功能及肝纤维化指标透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CIV)、层粘连蛋白(LN),并进行血流动力学检查。结果:治疗后治疗组积分值显著下降,与治疗前比较,差异有非常显著性意义(P<0.01);对照组也有下降,与治疗前比较,差异有显著性意义(P<0.05);治疗组改善优于对照组(P<0.05)。2组治疗后谷丙转氨酶(ALT)均稍下降,但与治疗前比较,差异均无显著性意义(P>0.05);总胆红素(TBil)、血清白蛋白(Alb)治疗组下降明显,与治疗前比较,差异均有非常显著性意义(P<0.01)。治疗2月后,治疗组门静脉内径、血流量明显下降,与治疗前比较,差异有显著性意义(P<0.05),与对照组治疗后比较,差异也有显著性意义(P<0.05)。血流速度治疗组治疗前后差异不显著。结论:加味瓜蒌散能够改善肝硬化门静脉高压症患者临床症状、体征及肝功能,有效调节血流动力学,降低纤维化指标以干预门脉高压的形成,疗效优于普萘洛尔,是防治肝硬化门脉高压症的有效方剂。Objective:To observe the therapeutic effect of Modified Gualou Powder(MCP)for the treatment of liver cirrhosis with portal hypertension.Methods:Forty liver cirrbosis patients with portal hypertension,which are differentiated as blood-atasis blooking collaterals were equally randomised into two groups.The two groups received treatment for protecting liver and decreasing alanine aminotrassferase(ALT).Meanwhile,the control group received propranolol and the treatment group received MGP additionally.The soores of symptoms and signs were observed before and after treatment,bepatic function and liver fibrosis parameters such as hyaluronic acid(HA),procollagenⅢ(PCⅢ),collagen TV(CIV)and laminin(LN)were detected.Meanwhile,the hemodynamicsa was also examined.Results:The scores of symptoms and signs were decressed in the treatment group (P<0.01)and in the control group(P<0.05)after treatment,the decrease being obvious in the treatment group(P<0.05 compared with that in the control group).The decrease of ALT was insignificant is the two groups after treatment(P>0.05 compared with that before treatment).Total bilirubin(TBil)and serum albumin(Alb)were decreased in the two groups(P<0.01).After treatment for 2 months,the portal vein diameter and blood flow in portal vein were lowered in the treatment group(P<0.05 compared with those before treatment)and the decrease was more obvious than that in the control group(P<0.05).The difference of blood flow velocity before and after treatment was not obvious in the treatment group.Conclusion:MGP has a better therapeutic affect for liver cirrbosis with portal hypertension than propranolol by relieving symptoms and signs and promoting hepatic function,effectively regulating hemodynamic parameters,decreasing liver fiborsis parametern and intervening the formation of portal hypertension.

关 键 词：门静脉高压症 肝硬化 中医疗法 加味瓜萎散 

分 类 号：R544.1[医药卫生—心血管疾病]