麝龙散敷脐配合利尿剂治疗肝脾血瘀型肝硬化腹水并门脉高压的临床疗效  

The clinical efficacy of Shelong Powder on the navel combined with diuretics in the treatment of ascites and portal hypertension in patients with liver and spleen blood stasis type cirrhosis

作　　者：韩国华[1] 刘春光[1] 闫彦昌 孟春荣[3] 方康 王晨宇 HAN Guohua;LIU Chunguang;YAN Yanchang;MENG Chunrong;FANG Kang;WANG Chenyu(Department of Hepatology,Weifang Hospital of Traditional Chinese Medicine,Weifang261041,China;Department of Geriatrics,Weifang Hospital of Traditional Chinese Medicine;Department of Ultrasonography,Weifang Hospital of Traditional Chinese Medicine)

机构地区：[1]潍坊市中医院肝病科,山东潍坊261041 [2]潍坊市中医院老年病科 [3]潍坊市中医院超声科

出　　处：《潍坊医学院学报》2023年第6期405-408,共4页Acta Academiae Medicinae Weifang

基　　金：山东省中医药科技发展计划项目(项目编号:2019-0701)。

摘　　要：目的探究麝龙散敷脐配合利尿剂治疗肝脾血瘀型肝硬化腹水并门脉高压的临床疗效。方法选取2019年6月~2021年6月收治的肝脾血瘀型肝硬化腹水并门脉高压患者60例,随机分为对照组和观察组,各30例。两组均以利尿剂做基础治疗,对照组安慰剂敷脐,观察组麝龙散敷脐,治疗1个月。比较两组患者治疗前后证候积分、腹围、体重、肝功能、凝血4项以及门、脾静脉血流动力学指标。结果治疗后观察组证候积分低于对照组(P<0.05);治疗有效率高于对照组(93.33%vs 70.00%,P<0.05);腹围、体重以及腹水暗区深度低于对照组,24h尿量高于对照组(P<0.05);ALT、AST、GGT、TBIL、部分凝血酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、门静脉内径(Dpv)、脾静脉内径(Dsv)、门静脉最大血流速度(Vmaxpv)、脾静脉最大血流速度(Vmaxsv)、门静脉每分钟血流量(Qpv)和脾静脉每分钟血流量(Qsv)低于对照组,纤维蛋白原(FIB)高于对照组(P<0.05)。结论对肝脾血瘀型肝硬化腹水并门脉高压患者行中药麝龙散敷脐联合利尿剂治疗,能降低腹水量,改善凝血功能以及门、脾静脉血流动力学指标,效果显著。Objective To investigate the clinical efficacy of Shelong Powder on the navel combined with diuretics in the treatment of ascites and portal hypertension in patients with liver and spleen blood stasis type cirrhosis.Methods From June 2019 to June 2021,60 patients with cirrhotic ascites and portal hypertension of liver spleen blood stasis type were randomly divided into control group and observation group,with 30 cases in each group.Both groups were treated with diuretics,the control group was given placebo on the navel,and the observation group was given Shelong Powder on the navel.Both groups were treated for one month.Compare the differences in syndrome scores,abdominal circumference,body weight,liver function,blood coagulation,and hemodynamic indexes of portal and splenic veins between the two groups before and after one month of treatment.Results After one month,the TCM syndrome scores in the observation group were lower than those in the control group(P<0.05);The effective rate of treatment was higher in the control group(93.33%vs 70.00%,P<0.05);The abdominal circumference,body weight,and depth of ascites dark zone in the observation group were lower than those in the control group.The 24-hour urine volume in the observation group was higher than that in the control group(P<0.05);The ALT,AST,GGT,TBIL,APTT,PT,TT,Dpv,Dsv,Vmaxpv,Vmaxsv,Qpv,and Qsv in the observation group were lower than those in the control group,while FIB in the observation group was higher than that in the control group(P<0.05).Conclusion Applying Shelong Powder to the navel combined with diuretic therapy can reduce the amount of ascites,improve liver function,blood coagulation,portal and splenic venous hemodynamics in patients with cirrhotic ascites and portal hypertension due to liver and spleen blood stasis.The effect is outstanding.

关 键 词：肝硬化 腹水 门静脉高压 肝脾血瘀型 麝龙散 

分 类 号：R256.4[医药卫生—中医内科学]