川芎嗪配伍心得安预防食管静脉曲张破裂出血的临床对照研究  

A randomized controlled study of ligustrazine in combination with propranolol for prevention of recurrent esoph- ageal varices bleeding

作　　者：李孝生[1] 沈鼎明[1] 邹建忠[1] 刘长安[1] 张炼[1] 

机构地区：[1]重庆医科大学附属第二医院消化内科,400010

出　　处：《中华肝脏病杂志》2000年第2期99-101,共3页Chinese Journal of Hepatology

摘　　要：目的探讨川芎嗪配伍心得安预防肝硬化食管静脉曲张破裂出血 （ｅｓｏｐｈａｇｅａｌ ｖａｒｉｃｅｓ　ｂｌｅｅｄｉｎｇ，ＥＶＢ）复发的效果及其作用机制。方法对３８例治疗组患者和３６例对照组患者进行前瞻性对照研究，在用药前后用彩色多普勒超声仪检测其门静脉系统血流动力学的变化，并动态监测患者的血压、心率、肝、肾功能及ＥＶＢ复发情况。结果用药１周后治疗组门静脉内径、脾静脉血流量显著下降，于４周后门静脉血流量、脾静脉血流量、门静脉内径、脾静脉内径，分别下降为（１１５２．３６ ± ３８７．４６） ｍｌ／ｍｉｎ，（５２９、３５ ± ３２６．３） ｍｌ／ｍｉｎ，（１．３６ ± ０．２８） ｃｍ，（０．９４ ± ０．１９） ｃｍ，与用药前比较有显著差异，临床上未见明显副反应；随访２年，对照组再出血率和病死率均显著高于治疗组，两组中Ｃｈｉｌｄ Ｃ级患者的再出血率和病死率无显著差异。结论小剂量川芎嗪与心得安联用预防ＥＶＢ复发是安全有效的，值得在临床进一步研究和试用。Objective To assess the efficacy of Ligustrazine in combination with propranolol in the prevention of recurrent esophageal varices bleeding following liver cirrhosis, and its act mechanism. Methods A prospective controlled study was conducted on 74 patients, in whom 38 belonged to treatment group, and 36 to control group. By detecting the portal system hemodynamics in patients with portal hypertension and esophageal varices using color Doppler ultrasound technique, the therapeutic efficacy and safety were investigated. Meanwhile the blood pressure, heart rate, hepatic and renal function were dynamically observed. Results After four weeks administration of the drugs, the flow of portal vein and splenic vein, the diameter of portal vein and splenic vein in the treatment group were significantly decreased with the values of 1152.36 ± 387.46 ml/min, 529.35 ± 326.31 ml/min, 1.36 ± 0.28 cm, and 0.94 ± 0. 19 cm, respectively. No adverse effect was observed on the system circulation and the liver function. In the follow-up period of two years, the rebleeding rate and mortality rate in t4e placebo group were higher than that in the treatment group, but patients with liver cirrhosis Grade C in the two groups were not significant different. Conclusion Low dose ligustrazine plus propranolol is a safe and effective therapy in preventing recurrent esophageal varices bleeding, and worth further trial.

关 键 词：肝硬化 食管静脉曲张 川芎嗪 心得安 EVB 

分 类 号：R571.3[医药卫生—消化系统]