肝豆状核变性脾切除肝功能变化对脾虚证的影响及健脾活血中药干预  

Effect of Hepatic Function Changes after Splenectomy on Spleen Deficiency Syndrome and Intervention of Chinese Herbs for Invigorating Spleen and Activating Blood Circulation

作　　者：卢兴洋 于庆生[1,2] LU Xingyang;YU Qingsheng(Anhui University of Traditional Chinese Medicine,Anhui Hefei 230031,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》2024年第3期565-569,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:观察肝豆状核变性(HLD)脾大脾亢行脾切除术患者肝功能的变化及其对脾虚证形成的影响,并探讨健脾活血中药的干预效果。方法:选取安徽中医药大学第一附属医院普外一科80例HLD脾大脾亢行脾切除术患者,随机分为观察组(40例)与对照组(40例),采用单因素分析肝功能对HLD脾切除患者脾虚证形成的影响,观察2组患者治疗前后丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、白蛋白(ALB)水平。并比较2组中脾虚证患者(观察组35例,对照组29例)的症状评分。结果:单因素分析结果显示术前与术后第1天ALT、AST、TBIL以及术前ALB水平与脾虚证形成有统计学意义;2组患者术前与术后第1天、第7天肝功能指标差异无统计学意义,术后第14天,观察组相比于对照组ALT、AST、DBIL水平显著下降,ALB水平显著升高,差异具有统计学意义。观察组运用健脾活血中药治疗脾虚证疗效明显优于对照组,差异具有统计学意义。结论:术前与术后早期肝功能是影响HLD脾切除患者脾虚证形成的重要因素,健脾活血中药显著地促进了脾切除术后肝功能恢复,同时对脾虚证的改善具有确切的疗效。Objective:To observe the changes of liver function in hepatolenticular degeneration( HLD) patients with splenomegaly and hypersplenism undergoing splenectomy and its effect on the formation of spleen deficiency syndrome,and to explore the intervention effect of traditional Chinese medicine for strengthening spleen and activating blood circulation.Methods:a total of 80 HLD patients with splenomegaly and hypersplenism undergoing splenectomy were randomly divided into observation group( n = 40) and control group( n = 40),and the influence of liver function on the formation of spleen deficiency syndrome in HLD patients undergoing splenectomy was analyzed by univariate analysis.The levels of alanine aminotransferase( ALT),aspartate aminotransferase( AST),total bilirubin( TBIL),direct bilirubin( DBIL) and albumin( ALB) were observed before and after treatment.The symptom scores of the patients with spleen deficiency syndrome in the two groups( 35 cases in the observation group and 29 cases in the control group) were compared.Results:The results of univariate analysis showed that the levels of ALT,AST,TBIL before operation and the first day after operation and ALB before operation were significantly related to the formation of spleen deficiency syndrome( P < 0.05);There was no significant difference in liver function indexes between the two groups before operation and on the first and seventh day after operation( P > 0.05),but on the fourteenth day after operation,the levels of ALT,AST and DBIL in the observation group were significantly lower than those in the control group( P < 0.05),and the level of ALB was significantly higher( P < 0.05).The observation group was significantly better than the control group in the treatment of spleen deficiency syndrome with Jianpi Huoxue Chinese medicine,the difference was statistically significant( P < 0.05).Conclusion:Preoperative and early postoperative liver function is an important factor in the formation of spleen deficiency syndrome in patients with HLD after splenectomy,and

关 键 词：脾切除 肝功能 脾虚证 健脾活血 

分 类 号：R575.24[医药卫生—消化系统]