复方三黄饮治疗肝硬化合并上消化道静脉曲张破裂出血的临床疗效研究  

Study on clinical efficacy of Compound Sanhuang Yin in treating liver cirrhosis complicating upper gastrointestinal variceal rupture bleeding

作　　者：周显华 金晓慧 尚天菊 尚亚楠 赵波 宋晓蓉[1] 严展 孙俊杰 晏友君 ZHOU Xianhua;JIN Xiaohui;SHANG Tianju;SHANG Yanan;ZHAO Bo;SONG Xiaorong;YAN Zhan;SUN Junjie;YAN Youjun(Department of Digestion,Meishan Municipal Hospital of Traditional Chinese Medicine,Meishan,Sichuan 620000,China)

机构地区：[1]四川省眉山市中医医院消化科

出　　处：《重庆医学》2020年第3期401-404,共4页Chongqing medicine

基　　金：四川省眉山市科技局项目;四川省医学科研课题项目(S18030)

摘　　要：目的探讨复方三黄饮治疗肝硬化合并上消化道静脉曲张破裂出血的临床效果。方法将72例肝硬化合并食管胃底静脉曲张破裂出血患者根据入院先后顺序分为治疗组和对照组,每组各36例。两组患者均予以西医常规治疗,对照组在此基础上给予云南白药胶囊治疗,治疗组则给予复方三黄饮(以生大黄、黄芪、赶黄草、泽泻、甘草等多味中药为基本方)酌情加减治疗,1周后比较两组患者临床治疗效果。结果治疗前,两组患者肝功能、血氨、血浆内毒素、肠黏膜通透性、数字连接试验-A(NCT-A)时间及中医症状总积分比较,差异均无统计学意义(P>0.05);治疗后对照组患者丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)及中医症状总积分分别为(55.14±17.31)U/L、(46.42±8.46)U/L、(37.57±14.47)μmol/L、(17.6±1.67)分,治疗组分别为(37.28±11.23)U/L、(33.28±8.53)U/L、(23.57±5.47)μmol/L、(13.4±3.13)分,治疗组明显优于对照组(P<0.05);治疗后两组患者血浆内毒素水平及肠黏膜通透性相关指标、血氨水平、NCT-A时间均明显降低(P<0.05),且治疗组优于对照组(P<0.05)。结论复方三黄饮能有效改善肝硬化合并上消化道静脉曲张破裂出血患者肝功能及肠黏膜通透性等水平,值得临床推广应用。Objective To investigate the clinical effect of Compound Sanhuang Yin in the treatment of liver cirrhosis complicating upper gastrointestinal variceal rupture bleeding.Methods Seventy-two patients with liver cirrhosis complicating esophagogastric variceal rupture bleeding were divided into the treatment group and control group according to the order of admission,36 cases in each group.Both groups were treated with routine Western medicine.The control group was treated with Yunnan Baiyao Capsule on the basis of routine Western medicine.The treatment group was given Compound Sanhuang Yin(with multi flavor Chinese medicine of raw rhuharb,astragalus,Penthorum chinense Pursh,rhizome alismatis,glycyrrhiza,etc.as the basic formula)appropriate add and subtract treatment.The clinical effects after 1 week were compared between the two groups.Results Before treatment,there were no statistically significant differences in the liver function,blood ammonia,plasma endotoxin,intestinal mucosal permeability,number connection test-A(NCT-A)and total score of TCM symptoms between the two groups(P>0.05);after treatment,ALT,AST,TBIL and total score of TCM symptoms in the control group were(55.14±17.31)U/L,(46.42±8.46)U/L,(37.57±14.47)μmol/L and(17.6±1.67)points respectively,which in the treatment group were(37.28±11.23)U/L,(33.28±8.53)U/L,(23.57±5.47)μmol/L and(13.4±3.13)points,the treatment group was significantly better than the control group(P<0.05);plasma endotoxin,intestinal mucosal permeability related indexes,NH3,NCT-A levels after treatment in the two groups were significantly decreased(P<0.05),moreover the treatment group was superior to the control group(P<0.05).Conclusion Compound Sanhuang Yin can effectively improve the liver function,and intestinal mucosal permeability level in the patients with liver cirrhosis complicating upper gastrointestinal variceal rupture bleeding,which is worthy of clinical promotion and application.

关 键 词：肝硬化 静脉曲张破裂出血 复方三黄饮 数字连接试验-A 

分 类 号：R289.5[医药卫生—方剂学]