加味瓜蒌散对肝硬化门静脉高压症患者胃肠激素、肝纤维化指标和血流动力学的影响  

Effect of Jiaweigualou powder on blood gastrointestinal hormone,indexes of hepatic fibrosis and hemodynamics in patients with portal hypertention

作　　者：徐晓琦[1] 李民[1] 曹卫菊[1] 顾尔莉[1] 王陆军[1] 章幼奕[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,江苏南通226006 [2]南通大学医学院

出　　处：《中西医结合肝病杂志》2009年第2期70-72,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：江苏省南通市社会发展科技计划资助项目(No.S40019)

摘　　要：目的:观察加味瓜蒌散对肝硬化门静脉高压症患者胃肠激素、肝纤维化指标和血流动力学的影响。方法:选择符合2000年9月西安全国传染病与寄生虫病学术会议《肝硬化诊断标准》同时符合中医血瘀阻络证型肝硬化门脉高压症患者40例,随机分治疗组和对照组。两组患者均常规接受护肝、降酶等对症治疗,治疗组患者加服加味瓜蒌散,对照组患者加服心得安(通用名普萘洛尔)。治疗前后清晨空腹取血放射免疫法测胃肠激素胃动素(MTL)、胃泌素(GAS)、胰高血糖素(GLU)、脑肠肽(SS),肝纤维化指标透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(C-Ⅳ)、层粘连蛋白(LN),并进行血流动力学检查。结果:治疗组治疗后GAS、MTL水平明显下降(P<0.01或P<0.05),HA、PCⅢ、C-Ⅳ、LN下降(P<0.01或P<0.05),门静脉内径、血流量与用药前比较差异有显著性意义(P<0.05),血流速度治疗前后与对照组比较差异无显著性意义(P>0.05)。结论:加味瓜蒌散能够有效调节肝硬化门静脉高压症患者胃肠激素、血流动力学,降低纤维化指标,延缓门脉高压的形成,减轻门脉高压性胃病的程度,减少食管胃底静脉曲张破裂出血的机会及风险,疗效优于心得安,是防治肝硬化门脉高压症的有效方剂。Objective： To observe the influence of Jiaweigualou powder on blood gastrointestinal hormone, markers of hepatic fibrosis and hemodynamics in patients with portal hypertention. Methods： Forty cases of peptic ulcer were selected and divided randomly into two groups. The two groups all were treated with normal decreasing enzymc to protect liver, besides this, the treated group were treated with Jiaweigualou powder and the control group were treated with propranolol. The morning venous blood was collected to determine the gastrointestinal hormone （motilin, gastrin, glucagon）, markers of hepatic fibrosis and hemodynamies of two groups before and after treatment. Results： The levels of GAS and MTL decreased more prominently than those before treatment （P 〈 0. 05 or P 〈 0. 01 ） and the concentration of HA, PC Ⅲ, C-Ⅳ, LN decreased （P 〈 0. 05 or P 〈 0. 01 ） . The difference was significant of portal vein diameter and blood flow volume compared with that of the pre-treatment （P 〈0. 05） . There were no difference of the blood flow velocity in the treatment group pre and post treatment and in control group （P 〉 0. 05） . Conclusion： Jiaweigualou powder effectively reduce the concentration of the gastrointestinal hormone, markers of hepatic fibrosis and hemodynamics in patients with portal hypertention, which was superior to proprasnonol group. Jiaweigualou powder is an effective prescription for cirrhotic portal hypertension.

关 键 词：加味瓜蒌散/治疗应用 门脉高压症 胃肠激素 肝纤维化指标 血流动力学 

分 类 号：R259[医药卫生—中西医结合]