加味瓜蒌散治疗乙型肝炎肝硬化食管胃静脉曲张的疗效  

Curative effect of Modified Gualou Powder on esophageal and gastric varices in patients with hepatitis B cirrhosis

作　　者：施亚军[1] 顾尔莉[1] 薛红[1] 王忠成[1] 张建荣[1] 李民[1] SHI Yajun;GU Erli;XUE Hong;WANG Zhongcheng;ZHANG Jianrong;LI Min(Hepatology Department of integrated Chinese and western medicine,Nantong Third People's Hospital(Affiliated Nantong Hospital 3 of Nantong University),Nantong 226006,China)

机构地区：[1]南通市第三人民医院(南通大学附属南通第三医院)中西医结合肝病科,南通226006

出　　处：《西北药学杂志》2023年第6期179-183,共5页Northwest Pharmaceutical Journal

基　　金：江苏省中医药科技发展计划项目(编号:2022093);江苏省南通市科技局资助项目(编号:MSZ18188)。

摘　　要：目的观察自制加味瓜蒌散治疗乙型肝炎肝硬化患者食管胃静脉曲张的临床疗效。方法将60例肝硬化门脉高压症的乙型肝炎肝硬化患者分为观察组(加味瓜蒌散治疗)和对照组(普萘洛尔治疗),利用电子胃镜、瞬时弹性扫描仪、血管假性血友病因子(von willeb rand factor,vWF)质量浓度检测、B超等方法,观察患者内镜下食管胃静脉曲张程度、红色征等的改变情况,B超下肝脾斜径、脾脏厚度、肝脏硬度值(liver hardness value,LSM)、vWF及相关指标的变化。结果治疗后,观察组内镜下食管胃静脉曲张程度、LSM、vWF和脾脏斜径等指标较治疗前均显著下降(P<0.05);对照组较治疗前仅内镜下食管胃静脉曲张程度显著下降(P<0.05),其余指标无显著变化。对照组用药前后血压、心率比较差异有统计学意义(P<0.05),观察组用药前后血压、心率比较差异无统计学意义。结论乙型肝炎肝硬化门脉高压症患者用加味瓜蒌散治疗能改善内镜下食管胃静脉曲张程度、减少红色征、改善肝脏硬度值、缩小脾脏斜径。Objective To observe the clinical efficacy of self-made Modified Gualou powder in the treatment of esophageal and gastric varices in patients with hepatitis B cirrhosis.Methods Sixty patients with hepatitis B cirrhosis and portal hypertension were randomly divided into observation group(treated with Modified Gualou powder)and control group(treated with propranolol).Electronic gastroscopy,transient elastic scanner,von willebrand Factor(vWF)mass concentration detection,B-ultrasound and other methods were used to observe the changes of esophageal and gastric varices,the changes of esophageal and gastric varices,red signs,liver and spleen oblique diameters,changes in spleen thickness,liver hardness value(LSM),vWF,and related indicators were compared.ResultsAfter treatment,the observation group showed a significant decrease in the degree of esophageal and gastric varices,LSM,vWF,and splenic oblique diameter under endoscopy compared with before treatment(P<0.05).The control group showed a significant decrease in the degree of esophageal and gastric varices under endoscopy compared with before treatment(P<0.05),with no significant changes in other indicators.There was a statistically significant difference in blood pressure and heart rate before and after medication in the control group(P<0.05),while there was no statistically significant difference in blood pressure and heart rate before and after medication in the observation group.Conclusion Modified Gualou Powder can improve the degree of esophageal and gastric varices under endoscope,reduce red signs,improve the liver hardness and narrow the oblique diameter of spleen in patients with hepatitis B cirrhosis and portal hypertension.

关 键 词：加味瓜蒌散 普萘洛尔 肝硬化 门静脉高压 肝脏硬度 血管假性血友病因子 

分 类 号：R975[医药卫生—药品]