本文關(guān)鍵詞： 養(yǎng)血柔肝方 肝硬化代償期門脈高壓癥 臨床研究　出處：《廣西中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:觀察養(yǎng)血柔肝方治療肝硬化代償期門脈高壓癥患者的臨床療效,并與鹽酸普萘洛爾片對照組相比較,評價養(yǎng)血柔肝方對肝硬化代償期門脈高壓癥的治療效果。方法:選擇住院治療的符合肝硬化代償期門靜脈高壓癥診斷標準的患者60例,按隨機對照原則分為治療組(30例)和對照組(30例),對照組予鹽酸普萘洛爾片劑,治療組予養(yǎng)血柔肝方,兩組療程均為3個月。在治療前后分別觀察患者的臨床癥狀、體征、肝功能、血清肝纖維化指標、肝臟硬度值、食管胃底靜脈曲張程度、門靜脈內(nèi)徑(Diameter of portal vein,Dpv)、門靜脈血流速度(Velocity of portal vein,Vpv)的變化,比較兩組患者的療效。結(jié)果:(1)兩組患者治療后臨床癥狀、體征均有不同程度改善,中醫(yī)癥候總積分值下降。治療組療效明顯優(yōu)于對照組,組間比較差距有統(tǒng)計學意義。(P0.05)。(2)兩組病例治療后肝功能指標ALT,TBIL,ALB均有不同程度的好轉(zhuǎn)。兩組病例治療后ALT,TBIL下降水平差異顯著,組間比較有統(tǒng)計學意義(P0.05)。治療后兩組ALB均升高,但兩組之間的差異無統(tǒng)計學意義(P0.05)。(3)兩組治療后血清肝纖維化指標HA,PCⅢ,IV-C,LN均有不同程度下降,治療組治療前后差異有顯著性(P0.05),對照組治療前后比較差異無顯著性(P0.05)。兩組治療后比較(P0.05),差異有統(tǒng)計學意義。(4)兩組治療后肝臟硬度值下降,治療組治療前后差異有統(tǒng)計學意義(P0.05),對照組治療前后比較差異無顯著性(P0.05)。兩組治療后比較(P0.05),差異有統(tǒng)計學意義。(5)兩組治療后食管胃底靜脈曲張程度均有減輕,治療組與對照組比較(P0.05),差異具有統(tǒng)計學意義。(6)治療組服用養(yǎng)血柔肝方3個月后門靜脈內(nèi)徑、血流量與治療前比較差異具有顯著性(P0.05),血流速度治療后與對照組比較差異無顯著性(P0.05)。結(jié)論:養(yǎng)血柔肝方能有效改善肝硬化代償期門脈高壓癥患者的臨床癥狀及體征,改善肝功能,降低血清肝纖維化指標,減輕食管胃底靜脈曲張程度,能夠使患者門靜脈內(nèi)徑回縮及門靜脈血流量較前下降。其作用機制體現(xiàn)了養(yǎng)血柔肝方的“柔肝軟堅”功效,具體療效機制有待于進一步明確。
[Abstract]:Objective: to observe the clinical effect of Yangxuelugan recipe in treating patients with compensatory portal hypertension of liver cirrhosis, and compare with the control group of propranolol hydrochloride. Objective: to evaluate the therapeutic effect of Yangxuelugan recipe on compensatory portal hypertension in cirrhotic patients. Methods: sixty patients with compensatory portal hypertension of liver cirrhosis were selected for inpatient treatment. According to the principle of random control, they were divided into treatment group (n = 30) and control group (n = 30). The control group was given propranolol hydrochloride tablet and the treatment group was given Yangxue Rugan recipe for 3 months. The clinical symptoms and signs of the patients were observed before and after treatment. Changes of liver function, serum hepatic fibrosis index, liver hardness, degree of esophageal and gastric varices, diameter of portal vein diameter of portal veinDpvn, portal vein velocity of portal velocities in VPV). Results after treatment, the clinical symptoms and signs of the two groups were improved to some extent, and the total integral value of TCM symptoms decreased. The curative effect of the treatment group was significantly better than that of the control group. The difference between the two groups was statistically significant (P < 0.05).) after treatment, the liver function index (alt) TBIL-ALB of the two groups were improved to some extent, the level of alt TBIL decreased significantly after treatment, and there was significant difference between the two groups (P 0.05). After treatment, the ALB of the two groups were all increased. But there was no significant difference between the two groups. There was significant difference before and after treatment in the treatment group, but there was no significant difference between the control group and the control group before and after treatment. After treatment, there was a significant difference between the two groups (P 0.05), the difference was statistically significant (P < 0.05). There was significant difference before and after treatment in the treatment group (P 0.05), but there was no significant difference between the control group (P 0.05) and the control group (P 0.05). After treatment, there was a significant difference between the two groups (P 0.05) the degree of esophageal and gastric fundus varices in the two groups was reduced after treatment, and there was no significant difference between the two groups before and after treatment. The difference between the treatment group and the control group was statistically significant. The blood flow was significantly different from that before treatment (P 0.05), but there was no significant difference between the blood flow velocity after treatment and the control group. Conclusion: Yangxue Rugan recipe can effectively improve the clinical symptoms and signs of patients with compensatory portal hypertension of liver cirrhosis. Improving liver function, reducing serum hepatic fibrosis index, reducing the degree of esophageal and gastric varices, can make portal vein internal diameter shrink and portal vein blood flow lower than before. The mechanism of curative effect needs to be further clarified.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259

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