中医治疗肝硬化门脉高压症的研究概况  

General Situation of Traditional Chinese Medicine in Treatment of Irrhotic Portal Hypertension

作　　者：曹爽 王春景 刘光伟[2] CAO Shuang;WANG Chunjing;LIU Guangwei(Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China;The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学,河南郑州450000 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《实用中医内科杂志》2020年第5期91-94,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：河南省科技厅重点研发与推广专项科技攻关项目(182102310272)。

摘　　要：门静脉提供人体肝脏总血流的75%及总氧量的60%,正常门脉压为5~10mmHg,若超过此界限,则称为门脉高压,门脉高压症便是由门脉高压引起的一系列临床综合征。门脉高压的病因以肝硬化最为常见,以脾功能亢进、出血、腹水为主要表现的肝硬化门脉高压症是导致肝硬化患者病死率增加的主要因素[2],因此加强对肝硬化门脉高压的防治是影响肝硬化患者病情转归的重要因素。目前西医治疗以收缩舒张血管作用的非选择性β-受体阻滞剂为主,以临床常见的心得安为例,在门静脉高压治疗中具有一定的优势,但越来越多的研究也表明,长期使用不利于肝功能改善和尿素合成,可引起肝缺血、缺氧甚至再出血等,并不能达到治病治本的目的,且禁忌症多、不良反应较大。门脉高压症的临床表现多样,故虽然古代医籍中无肝硬化门脉高压的统一病名,但"积聚""鼓胀""血证"等均为其相关的症状。中医以其整体观和辨证论治的观念,凸显了在该领域的优势,更以其治疗方法的多样性成为研究热点。如采用现代科学技术加工而成的中成药,在保证疗效的基础上又具有使用方便、保存容易、药性平稳等特点;又如中药外敷以脏腑学说为基础,局部用药,直达病灶,避免了口服药物加重胃肠道负担,以及肝肾损伤。对不同病情采取合适的独具特色的中医治疗方法,提高疗效的同时也能提高患者的依从性。文章就近5年来中医治疗肝硬化门脉高压症的研究概况进行综述,旨在为临床治疗提供更为多样的诊疗思路与方法。The portal vein provides 75%of total liver blood flow and 60%of total oxygen.The normal portal pressure was 5-10 mm Hg.If it exceeds this limit,it is called portal hypertension.Portal hypertension is a series of clinical syndromes caused by portal hypertension.Hepatocirrhosis is the most common cause of portal hypertension.Cirrhotic portal hypertension characterized by hypersplenism,hemorrhage and ascites is the main cause of increased mortality in patients with liver cirrhosis.Therefore,strengthening the prevention and treatment of portal hypertension in cirrhosis is an important factor affecting the prognosis of patients with cirrhosis.At present,western medicine mainly uses non-selective beta-blockers to constrict and relax blood vessels,and propranolol,a common clinical drug,has certain advantages in the treatment of portal hypertension.However,more and more studies also show that long-term use is not conducive to the improvement of liver function and urea synthesis,and would cause liver ischemia,hypoxia and even re-bleeding,and can not achieve the purpose of treatment,and there are many contraindications or side effects.The clinical manifestations of portal hypertension are various.Therefore,although there is no unified name of portal hypertension in cirrhosis in ancient medical books,"accumulation","swelling"and"blood syndrome"are all related symptoms.With its holistic thinking and the concept of syndrome differentiation and treatment,TCM has highlighted its advantages in this field,and its diversity of treatment methods has become a research hotspot.For example,the Chinese patent medicine processed by modern science and technology has the characteristics of convenient use,easy preservation and stable medicinal properties on the basis of guaranteeing the curative effect.For example,the external application of Chinese patent medicine is based on the theory of Zang-fu organs,local medication,direct access to the lesion,avoiding the oral medication aggravating the burden of gastrointestinal tract,as well as li

关 键 词：肝硬化 门脉高压症 中医治疗 

分 类 号：R259[医药卫生—中西医结合]