清中汤合丹参饮治疗门静脉高压性胃病临床研究  

Clinical Study of Qingzhong Decoction and Danshen Decoction for Portal Hypertensive Gastropathy

作　　者：李广鉴[1] 杜丽明[2] 孙秋[1] 王文鸽[2] 李晨 赵利[1] LI Guangjian;DU Liming;SUN Qiu;WANG Wenge;LI Chen;ZHAO Li(Hepatology department of Integrated Medicine,Kai Luan General Hospital,Tangshan,Hebei 063000;不详)

机构地区：[1]开滦总医院中西医结合肝胆科,河北唐山063000 [2]开滦总医院中医科,河北唐山063000 [3]开滦总医院药剂科,河北唐山063000

出　　处：《河北中医》2021年第6期938-942,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2019年度中医药类科研计划课题(编号:2019265)。

摘　　要：目的观察清中汤合丹参饮治疗门静脉高压性胃病(PHG)的临床疗效。方法将260例PHG患者按照年龄、性别分层随机化分组法分为2组,对照组128例予常规西药治疗,治疗组132例在对照组治疗基础上予清中汤合丹参饮治疗,28 d为1个疗程,共治疗3个疗程。比较2组治疗前及治疗1个疗程血小板计数(PLT)、总胆红素(TBiL)、凝血酶原时间国际标准化比值(INR)、血浆D-二聚体(D-D)、C反应蛋白(CRP)、抗胃壁细胞抗体(PCA)阳性率及幽门螺杆菌(Hp)感染阳性率,并统计2组治疗1、3个疗程临床症状及胃镜下疗效。结果治疗1个疗程治疗组PLT较本组治疗前升高(P<0.05),TBiL、INR、D-D、CRP均较本组治疗前降低(P<0.05),对照组PLT、INR、D-D均较本组治疗前升高(P<0.05),CRP降低(P<0.05),且治疗1个疗程治疗组PLT高于对照组同期(P<0.05),TBiL、INR、D-D、CRP均低于对照组同期(P<0.05)。治疗1个疗程2组Hp感染阳性率均较本组治疗前降低(P<0.05),治疗1个疗程2组内PCA阳性率及2组间PCA阳性率和Hp感染阳性率比较差异均无统计学意义(P>0.05)。治疗3个疗程治疗组临床总有效率、胃镜总有效率均高于本组治疗1个疗程(P<0.05),且治疗1、3个疗程治疗组临床总有效率、胃镜总有效率均高于对照组同期(P<0.05)。结论清中汤合丹参饮治疗PHG可以有效改善患者临床症状及胃镜下黏膜病变程度,改善肝功能、凝血指标、炎症指标,临床疗效显著。Objective To investigate the clinical effect of Qingzhong Decoction and Salvia Miltiorrhiza Decoction for portal hypertensive gastropathy(PHG).Methods Totally 260 patients with PHG were randomly divided into two groups according to age and sex differences,128 patients in control group were given basic treatment,132 cases in treatment group additionally with Qingzhong Decoction and Danshen Decoction on the basis of control group.Treatment lasted for 3 courses,a course for 28 days.Platelet(PLT)count,total bilirubin(TBiL),international normalized ratio(INR),plasma D-dimer(DD),C-reactive protein(CRP),the positive rate of anti-parietal cell antibody(PCA)and Helicobacter pylori(Hp)infection were compared before treatment and after 1 course of treatment,and clinical symptoms and endoscopic gastric mucosal lesions was counted after 1 and 3 courses of treatment.Results After 1 course of treatment,PLT in treatment group was significantly increased compared with before treatment(P<0.05),TBiL,INR,D-D and CRP were significantly decreased(P<0.05);PLT,INR and D-D in control group were higher than that before treatment(P<0.05),and CRP was lower(P<0.05);and the improvement level of indicators in treatment group was significantly better than that in control group(P<0.05);the positive rate of Hp infection in groups was significantly lower than that before treatment(P<0.05),with no significant difference between groups(P>0.05).After 3 course of treatment,the total effective rate(clinical symptom and endoscopic gastric mucosal lesion)in treatment group was significantly higher compared with 1 course(P<0.05),the improvement level of total effective rate in treatment group after 1 and 3 course of treatment were significantly better than that in control group during the same period of time(P<0.05).Conclusion For PHG patients,combination of the above two can effectively improve the clinical symptoms and endoscopic gastric mucosal lesions,liver function,coagulation indicators and inflammation indicators,with significant clinical efficacy.

关 键 词：丹参饮 高血压 门静脉 胃病 肝硬化 中药疗法 

分 类 号：R657.34[医药卫生—外科学] R573.053.1[医药卫生—临床医学]