柔肝化纤颗粒治疗肝硬化门脉高压的疗效及对患者肝静脉压力梯度的影响  

Efficacy of Rougan Huaxian Granules in the Treatment of Cirrhotic Portal Hypertension and Its Impact on Hepatic Venous Pressure Gradient

作　　者：何坚科 张文富[3] 吴姗姗 王振常[1,4] HE Jian-ke;ZHANG Wen-fu;WU Shan-shan;WANG Zhen-chang(The Affiliated International Zhuang Medicine Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi,530201;Graduate School,Guangxi University of Chinese Medicine,Nanning,Guangxi,530200;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning,Guangxi,530023;Guangxi Key Lab-oratory of Translational Medicine for Treating High-Incidence Infectious Diseases with Integrative Medicine,Nanning,Guangxi,530299)

机构地区：[1]广西中医药大学附属国际壮医医院,广西南宁530201 [2]广西中医药大学研究生院,广西南宁530200 [3]广西中医药大学第一附属医院,广西南宁530023 [4]广西高发传染病中西医结合转化医学重点实验室,广西南宁530299

出　　处：《广西中医药大学学报》2025年第2期5-9,共5页Journal of Guangxi University Of Chinese Medicine

基　　金：广西中医药适宜技术开发与推广项目(编号:GZSY21-45);广西自然科学基金项目(编号:2020GXNSFDA297021)。

摘　　要：[目的]观察柔肝化纤颗粒配合西医治疗肝硬化门脉高压的疗效及对患者肝静脉压力梯度的影响。[方法]选择64例肝硬化门脉高压患者,将其随机分为对照组和治疗组,每组32例。对照组给予西医常规护肝及对症治疗,治疗组在对照组治疗的基础上加用柔肝化纤颗粒口服治疗,分别治疗6个月后,观察两组患者临床疗效以及中医证候积分、肝功能、肝纤四项[透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)]、肝静脉压力梯度[肝静脉游离压(FHVP)、肝静脉锲入压(WHVP)和肝静脉压力梯度(HVPG)]等指标的变化情况。[结果]治疗组临床总有效率为93.75%,对照组总有效率为65.63%,治疗组疗效优于对照组(P<0.05);治疗后两组患者中医证候积分、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)、HA、LN、PCⅢ、Ⅳ-C、HVPG和WHVP水平均较治疗前下降(P<0.05),且治疗组较对照组下降更明显(P<0.05);治疗后两组患者白蛋白(ALB)水平较治疗前升高,且治疗组较对照组升高更明显(P<0.05)。[结论]柔肝化纤颗粒治疗肝硬化患者门脉高压时,能显著改善患者肝功能,有效缓解其门脉高压引发的临床症状,抑制肝纤维化,降低肝静脉压力梯度,具有潜在预防静脉曲张破裂出血的作用。[Objective]To observe the efficacy of Rougan Huaxian granules combined with western medicine in the treatment of cirrhotic portal hypertension and its impact on clinical hepatic venous pressure gradient(HVPG).[Methods]Sixty-four patients with cirrhotic portal hypertension were randomly divided into the control group and the treatment group,with 32 in each.The control group received conventional liver protection and symptomatic treatment with western medicine,while the treatment group received additional oral administration of Rougan Huaxian granules on the basis of the control group's treatment.After 6 months of treatment,the clinical efficacy,as well as changes in Traditional Chinese Medicine(TCM)syndrome scores,liver function,liver fibrosis indicators[hyaluronic acid(HA),laminin(LN),typeⅢprecollagen(PCⅢ),typeⅣcollagen(Ⅳ-C)],and hepatic venous pressure gradient[free hepatic venous pressure(FHVP),wedged hepatic venous pressure(WHVP),and HVPG]were observed in both groups.[Results]The clinical total effective rate was 93.75%in the treatment group and 63.63%in the control group,indicating that the treatment group had superior efficacy(P<0.05).After treatment,the TCM syndrome scores,the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBIL),HA,LN,PCⅢ,Ⅳ-C,HVPG and WHVP in both groups decreased compared with those before treatment(P<0.05).And the decrease was more significant in the treatment group than that in the control group(P<0.05).The albumin(ALB)lev⁃els increased in both groups after treatment compared with those before treatment.And the increase was more signifi⁃cant in the treatment group than that in the control group(P<0.05).[Conclusion]Rougan Huaxian granules can signif⁃icantly improve liver function,effectively alleviate clinical symptoms caused by portal hypertension,inhibit liver fi⁃brosis,and reduce HVPG in patients with cirrhotic portal hypertension.It has a potential role in preventing variceal bleeding.

关 键 词：肝硬化门脉高压 柔肝化纤颗粒 肝静脉压力梯度 中西医结合疗法 

分 类 号：R575.2[医药卫生—消化系统]