前列地尔联合补阳还五汤治疗门静脉血栓症临床研究  

Alprostadil combined with Buyang Huanwu decoction in treatment of liver cirrhosis with portal vein thrombosis

作　　者：王忠成[1] 顾尔莉[1] 王世蓬[1] 陈鸣鸣[1] 施亚军[1] 张建荣[1] 蔡晓娟[1] 朱敏[1] 

机构地区：[1]南通市第三人民医院肝病科,江苏南通210006

出　　处：《长春中医药大学学报》2017年第2期309-311,共3页Journal of Changchun University of Chinese Medicine

基　　金：江苏省中医药局课题"前列地尔联合中药补阳还五汤治疗门静脉血栓症研究"(LZ13167);江苏省南通市科技局项目(HS2013047)

摘　　要：目的探讨前列地尔联合补阳还五汤治疗肝硬化伴门静脉血栓症(PVT)的疗效。方法以我院2013年6月-2016年月3收治的肝硬化伴PVT32例患者为观察对象,随机分为治疗组15例,常规治疗加前列地尔10μg/d静滴及补阳还五汤协定方,1剂/d,对照组17例仅予以常规治疗。疗程1月,观察治疗前后血小板计数(PLT)、凝血酶原时间(PT)、国际标准化比值(INR)、抗凝血酶Ⅲ(ATⅢ)、门静脉内径(PVD)、血流速度(BFV)、脾静脉内径(SVD)、脾脏肋间厚度(ST)以及门脉血栓Yerdel的分级等指标。结果治疗组有5例出现血栓程度及范围的改善,对照组仅有1例;治疗组PLT降低,与治疗前比较,P<0.05,与对照组比较,P<0.05;治疗组ATIII升高,与治疗前及对照组治疗后比较均有统计学意义(P<0.05);治疗组治疗后PVD缩小,BFV增加,SVD增加,与治疗前比较,P<0.05,与对照组比较,在SVD差值、ST差值方面有统计学意义(P<0.05)。结论前列地尔联合补阳还五汤治疗PVT,对体内凝血、抗凝等指标以及门静脉血流动力学有一定的影响,可为肝硬化门静脉血栓的防治提供一种新的选择。Objective To observe the effect of alprostadil combined with Buyang Huanwu decoction on the treatment of liver cirrhosis with PVT. Methods PVT32 patients with cirrhosis of the liver treated in our hospital were observed during the period from June 2013 to March 2016. We divided all the cases into two groups. The treatment group 15 cases, using conventional treatment with alprostadil intravenous infusion of 10ug/d and Buyang Huanwu decoction 1 party agreement,1 agent/d, 17 eases in the control group only received routine treatment. A course of treatment is 1 months. To observe the PLT, PT, ATIII, the portal vein diameter（PVD）, blood flow velocity（BFV）, splenic vein diameter （SVD）, Spleen thickness （ST） and Yerdel grading before and after treatment. Results In the treatment group, there were 5 cases with the improvement of the degree and scope of thrombosis, and only 1 case in the control group. PLT of the treatment group was reduced, compared with before treatment, P〈0.05, compared with the control group, P〈0.05. The treatment group of ATIII increased, compared with the treatment before and after treatment were statistically significant （P 〈 0.05）.In the treatment group after treatment, PVD decreased, BFV increased, SVD increased, compared with before treatment, P 〈 0.05, compared with the control group, the difference in ST, SVD difference was statistically significant （P 〈 0.05）.Conclusion Alprostadil combined with Buyang Huanwu decoction is a safe and effective measures which have certain influence on the coagulation, anticoagulation and portal vein hemodynamics and other indicators, and can provide a new choice for the prevention and treatment of PVT.

关 键 词：前列地尔 补阳还五汤 肝硬化 门静脉血栓 

分 类 号：R274.9[医药卫生—中西医结合]