肝豆状核变性患者脾切除后血瘀证变化规律及健脾活血法治疗效果  

The Change Rule of Blood Stasis Syndrome in Patients with Hepatolenticular Degeneration after Splenectomy and the Therapeutic Effect of Strengthening the Spleen and Promoting Blood Circulation

作　　者：叶芸 胡高斌 黄龙[1,2] 王振 彭辉[1,2] 于庆生 YE Yun;HU Gaobin;HUANG Long;WANG Zhen;PENG Hui;YU Qingsheng(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China;Institute of Traditional Chinese Surgery of Anhui Academy of Chinese Medicine Sciences,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031 [2]安徽中医药科学院中医外科研究所,安徽合肥230031

出　　处：《中医药临床杂志》2021年第9期1770-1774,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：十二五国家临床重点专科建设项目(财社[2013]239号)。

摘　　要：目的:研究脾切除后患者血瘀证变化规律及中医药对脾切除后血瘀证的治疗作用。方法:选择2015年1月—2018年6月行脾切除术的45例HLD患者,随机分为对照组和观察组,对照组术后常规补液、护肝、抗感染和营养支持治疗;观察组在常规治疗方案外,还给予健脾活血中药治疗,治疗6~8周。术后常规监测PLT、D-二聚体、血流变和门静脉系统彩超,观察脾切除术后血瘀证治疗情况。结果:HLD脾切除术后PLT、D-二聚体和血流变各项指标自术后第1天起逐渐升高,2组PLT、D-D二聚体各时间点与术前相比,差异有统计学意义;2组术后第5天、第7天组间比较,观察组优于对照组,差异有统计学意义。结论:脾切除后PLT、D-二聚体和血流变的升高会对血瘀证的发生存在一定的影响作用,术后服用补中益气汤合桃红四物汤加减的中药能有效减少血瘀证发生的危害,降低血栓的形成。Objective:To study the changes of blood stasis syndrome in patients after splenectomy and the therapeutic effect of traditional Chinese medicine on blood stasis syndrome after splenectomy.Methods:45 HLD patients who underwent splenectomy from January 2015 to June 2018 were selected and randomly divided into control group and observation group.The control group was treated with routine fluid supplementation,liver protection,anti-infection and nutritional support after operation;observation group In addition to the conventional treatment plan,Chinese medicine for invigorating the spleen and promoting blood circulation was also given for 6 to 8 weeks.Postoperative routine monitoring of PLT,D-dimer,blood rheology,and portal venous system color Doppler ultrasound were performed to observe the treatment of blood stasis syndrome after splenectomy.Results:After HLD splenectomy,PLT,D-dimer and blood rheology index gradually increased from the first day after surgery.The time points of PLT and DD dimer in the two groups were different from those before operation.There is statistical significance;the comparison between the two groups on the 5th and 7th day after operation,the observation group is better than the control group,and the difference is statistically significant.Conclusion:After splenectomy,the increase of PLT,D-dimer and blood rheology will have a certain effect on the occurrence of blood stasis syndrome.It is effective to take Buzhong Yiqi Decoction and Taohong Siwu Decoction after operation.Reduce the harm of blood stasis syndrome and reduce the formation of thrombosis.

关 键 词：脾切除 血瘀证 健脾活血法 

分 类 号：R525[医药卫生—内科学]