当归芍药散对酒精性肝硬化伴门脉高压性腹水患者的血清ET-1及VEGF水平的影响  

Effects of Danggui Shaoyao San on Serum ET-1 and VEGF Level in Patients with Alcoholic Cirrhosis Associated with Portal Hypertension Ascites

作　　者：赖志红[1,2] 袁云芬[1] 

机构地区：[1]成都中医药大学附属医院,成都610072 [2]成都中医药大学,成都610072

出　　处：《中国实验方剂学杂志》2015年第1期195-198,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:评价当归芍药散治疗酒精性肝硬化(alcoholic cirrhosis,AC)伴门脉高压性腹水的疗效,并探讨其作用机制。方法:将符合条件的70例患者按1∶1比例随机分至治疗组和对照组,两组均予常规的西医治疗,治疗组在此基础上加用当归芍药散,疗程为1个月。记录其体重、腹围及24 h尿量的变化;采用彩色多普勒超声仪测定门静脉主干及脾静脉内径、计算门静脉血流量,全自动生化分析法测血清丙氨酸转氨酶(alanine aminotransferase,ALT),白蛋白(albumin,ALB),总胆红素(total bilirubin,TBIL)水平,全自动血凝分析法测凝血酶原时间活动度(prothrombin activity,PTA)水平,ELISA法测血清内皮素-1(endothelin-1,ET-1)含量,放射免疫法测血清血管内皮生长因子(vascular endothelial growth factor,VEGF)含量。结果:两组基线方面的差异无显著性,具有可比性。疗程结束后,治疗组在体重、腹围和尿量的改善及总体疗效方面均显著优于对照组(P<0.05);在门静脉血流量、门静脉主干及脾静脉内径的降幅上均大于对照组(P<0.05);在血清ALB,TBIL和血浆PTA水平方面的改善优于对照组(P<0.05);在血清ET-1和VEGF含量的下降幅度上均要大于对照组(P<0.05);而在血清ALT水平上两者无显著性差异。结论:当归芍药散具有促进酒精性肝硬化门脉高压性腹水消退、改善肝功能及凝血功能的综合作用,其疗效机制可能与抑制ET-1和VEGF的活性有关。Objective： To observe the effects of Danggui Shaoyao San on alcoholic cirrhosis with portal hypertension ascites and to discuss its mechanism. Method： A randomized controlled trial was conducted. Seventy patients were assigned to western medical treatment （control group） and western medical treatment plus Danggui Shaoyao San （ treatment group） for 1 month. The changes of body weight, abdominal perimeter and amount of urine were observed before and after treatment. The data related to portal hypertension was examined using color doppler ultrasound. Serum alanine aminotransferase （ALT）, aspartate aminotransferase （AST） and total bilirubin （TBIL） levels were measured via automatic biochemical analysis, plasma prothrombin time activity （PTA） level was measured via automatic coagulation analysis, endothelin-1 （ET-1） was measured via ELISA, svascular endothelial growth factor （VEGF） was measured via radioimmunoassay. Result： There was no significance difference for the baseline between two groups. Compared with control group, body weight, abdominal perimeter, amount of urine, data related to portal hypertension, liver function （TBIL, ALB） and coagulation function （PTA） were remarkably improved in treatment group （P 〈 0.05 ）. The levels of serum ET-1 and VEGF were significantly decreased in treatment group as compared with control group （P 〈 0.05 ）. However, there was no significance difference in serum ALT levels between two groups. Conclusion： Danggui Shaoyao San could significantly improve portal hypertension ascites, liver function and coagulation function in patients with alcoholic cirrhosis, and its mechanismmay be related to declining the activity of ET-1 and VEGF.

关 键 词：肝硬化 腹水 当归芍药散 机制 

分 类 号：R287.6[医药卫生—中药学]