健脾化湿方对乙型肝炎肝硬化患者1年内发生门静脉血栓的影响  

Effect of Spleen-invigorating dampness prescription on portal vein thrombosis in patients with hepatitis B cirrhosis within 1 year

作　　者：孟培培[1] 刘晓利[1] 吴桐 周洋 冀晓敏 杨玉英[1] 于浩[1] 侯艺鑫[1] MENG Pei-pei;LIU Xiao-li;WU Tong;HOU Yi-xing(Beijing Ditan Hospital,Capital Medical University,Beijing,100015,China)

机构地区：[1]首都医科大学附属北京地坛医院中西医结合中心,北京100015

出　　处：《中西医结合肝病杂志》2023年第10期877-880,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：北京市科学技术委员会“首都临床特色应用研究”资助项目(No.Z181100001718052);北京市医院管理中心“青苗”计划(No.QML20201802);北京市中医药科技发展资金项目(No.QN-2020-25);国家中医药管理局重大疑难疾病中西医临床协作试点项目(No.2018-6-4);国家中医药管理局区域中医诊疗中心(No.2019-3-18)。

摘　　要：目的:探讨健脾化湿方对乙型肝炎肝硬化患者1年内门静脉脉血栓(PVT)发生率的影响。方法:选取2013年1月至2018年12月首都医科大学附属北京地坛医院收治的乙型肝炎肝硬化患者451例,随访1年。根据1年内是否发生PVT,分为PVT组与非PVT组;通过Logistic回归方法分析影响PVT发生的独立危险因素,并观察健脾化湿方对PVT的预防作用。结果:两组患者的年龄、性别、基础病因、合并高血压、合并糖尿病、WBC、Alb、TBil、INR、APTT、FIB、PT、MELD评分比较,差异无统计学意义(P>0.05);非条件Logistic回归分析结果显示,有上消化道出血史、PLT升高、门静脉宽度增宽、未应用中药治疗是乙型肝炎肝硬化患者发生PVT的独立危险因素(P<0.05)。采用1∶1倾向性评分对两组患者进行匹配后,健脾化湿方组患者1年内PVT发生率8.2%,对照组为18.5%,健脾化湿方组患者PVT发生率较对照组下降10.3%,差异具有统计学意义(P<0.001)。结论:有上消化道出血史、PLT升高、门静脉宽度增宽、未应用中药治疗是乙型肝炎肝硬化患者发生PVT的独立危险因素。健脾化湿方能够降低乙型肝炎肝硬化患者1年内PVT发生率。Objective:To investigate the effect of Spleen-invigorating dampness prescription on portal vein thrombosis(PVT)in patients with hepatitis B Cirrhosis Within 1 year.Methods:A total of 451 patients with hepatitis B cirrhosis admitted to Beijing Ditan Hospital Affiliated to Capital Medical University from January 2013 to December 2018 were selected and followed up for 1 year.According to whether PVT occurred within 1 year,the patients were divided into PVT group and non-PVT group.The independent risk factors of PVT were analyzed by Logistic regression method,and the preventive effect of Jianpi Huashdampfang on PVT was observed.Results:There was no significant difference in age,sex,underlying cause,hypertension,diabetes,WBC,Alb,TBil,INR,APTT,FIB,PT and MELD score between two groups(P>0.05).Non-conditional logistic regression analysis showed that upper gastrointestinal bleeding history,PLT increase,portal vein width increase and not using traditional Chinese medicine were independent risk factors for PVT in patients with hepatitis B cirrhosis(P<0.05).After matching two groups with 1∶1 propensity score,the incidence of PVT was 8.2%in the Jianpi Huashi recipe group and 18.5%in the control group within one year.The incidence of PVT in the Spleen-invigorating dampness prescription group was decreased by 10.3%compared with that in the control group,the difference was statistically significant(P<0.001).Conclusion:History of upper gastrointestinal bleeding,increase of PLT,increase of portal vein width and non-treatment of TCM are independent risk factors of PVT in patients with hepatitis B cirrhosis.Spleen-invigorating dampness prescription can reduce the incidence of PVT in patients with hepatitis B cirrhosis within 1 year.

关 键 词：肝硬化 门静脉血栓 危险因素 中医药 

分 类 号：R575[医药卫生—消化系统]