基于“知肝传脾,脾反侮肝”脾切除序贯中药治疗门静脉高压症并脾功能亢进  

Based on "Knowing the Liver to Pass the Spleen,the Spleen Against the Liver" Splenectomy Sequential Traditional Chinese Medicine for the Treatment of Portal Hypertension and Hypersplenism

作　　者：潘刚 于庆生[2] 黄龙[2] 彭辉[1] PAN Gang;YU Qingsheng;HUANG Long;PENG Hui(Anhui University of Traditional Chinese Medicine,Anhui Hefei 230038,China;The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学,安徽合肥230031 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医药临床杂志》2021年第12期2365-2370,共6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:基于"知肝传脾,脾反侮肝"理论研究脾切除后序贯中医药对肝功能的恢复作用并探讨血常规、D-二聚体、血流变、血液动力学改变、门静脉系统血栓形成情况与肝功能变化之间的规律。方法:选择符合标准的因肝硬化门静脉高压症并脾功能亢进需要行脾切除的患者共80例,随机分为对照组和观察组,每组各40例,术后常规监测血常规、肝功能、D-二聚体、血流变、血液动力学及门静脉系统彩超,观察脾切除术后血常规、肝功能恢复情况以及D-二聚体、血流变、血液动力学改变和门静脉系统血栓形成情况。结果:①术后2组患者白细胞、红细胞、血小板均较术前明显改善,差异具有显著性,实验组肝功能改善情况优于对照组,差异具有显著性;②术后2组患者肝动脉血流量、峰值流量、肝动脉内径均较手术前明显改善,组间比较实验组肝动脉血流量、峰值流量优于对照组,P<0.05,差异具有统计学意义;③术后2组患者D-二聚体和血流变各项指标均显著升高,组间比较术后第5天开始实验组较对照组D-二聚体和血流变各项指标明显减低,术后门静脉系统血栓形成率显著低于对照组,P<0.05,差异具有统计学意义。结论:脾切除后序贯健脾活血中药能显著改善患者血常规、肝功能,能有效降低D-二聚体水平以及血液粘度,减少术后门静脉系统血栓发生率,利于肝功能的恢复。Objective:Based on the theory of “knowing the liver to pass the spleen,and the spleen against insulting the liver”,to study the effect of sequential Chinese medicine on the recovery of liver function after splenectomy,and to explore the changes in blood routine,D-dimer,blood rheology,hemodynamics,The rule between portal vein system thrombosis and liver function changes.Methods:A total of 80 patients who met the criteria and required splenectomy due to cirrhosis of portal hypertension and hypersplenism were selected and randomly divided into control group and observation group,each with 40 cases.Routine blood routine and liver function were monitored after operation.,D-dimer,blood rheology,hemodynamics and portal venous system color Doppler ultrasound,observe blood routine,liver function recovery after splenectomy,D-dimer,blood rheology,hemodynamic changes and portal venous system thrombosis Form the situation.Results:①After operation,the white blood cells,red blood cells,and platelets of the two groups were significantly improved compared with those before the operation,and the difference was significant.The improvement of liver function in the experimental group was better than that of the control group,and the difference was significant;②The hepatic artery blood of the two groups after the operation The flow,peak flow,and hepatic artery inner diameter were significantly improved compared with those before the operation.The hepatic arterial blood flow and peak flow of the experimental group were better than those of the control group in comparison between the groups (P<0.05),the difference was statistically significant;③D-in the two groups after surgery The indexes of dimer and blood rheology were significantly increased.The comparison between the groups started on the 5th day after the operation.Compared with the control group,the D-dimer and blood rheology indexes of the experimental group were significantly reduced.Postoperative portal vein thrombosis The rate was significantly lower than that of th

关 键 词：脾切除 脾功能亢进 健脾活血 中药 

分 类 号：R256.32[医药卫生—中医内科学]