本文選題：肝硬化門(mén)靜脈高壓癥　切入點(diǎn)：益氣　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本課題主要目的是觀察益氣解毒通絡(luò)方治療肝硬化門(mén)靜脈高壓癥的臨床療效,通過(guò)比較治療前后肝硬化門(mén)靜脈高壓癥患者的癥狀/體征、凝血功能、肝功能、腹部超聲等變化來(lái)探討和驗(yàn)證本治療方案的臨床有效性和實(shí)用性,同時(shí)觀察臨床使用中的不良反應(yīng)以評(píng)價(jià)其安全性,發(fā)揮中醫(yī)藥的特點(diǎn)和優(yōu)勢(shì),為肝硬化門(mén)靜脈高壓癥的臨床治療提供新思路。方法:研究對(duì)象均為北京中醫(yī)藥大學(xué)東直門(mén)醫(yī)院肝炎門(mén)診就診的患者,且符合本課題的入選標(biāo)準(zhǔn),共34例。34例研究對(duì)象均服用益氣解毒通絡(luò)方治療6個(gè)月,記錄、觀察、比較治療前后研究對(duì)象的中醫(yī)癥候積分、凝血功能、肝功能及門(mén)靜脈內(nèi)徑、脾靜脈內(nèi)徑等變化情況,使用SPSS21.0計(jì)算機(jī)統(tǒng)計(jì)分析軟件對(duì)統(tǒng)計(jì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果:(1)治療后患者的脅肋疼痛、納呆食少、倦怠乏力、脘腹脹滿(mǎn)癥狀和脅下痞塊、肝病面容較治療前明顯減輕(P0.01),出血癥狀(P0.05)較治療前減輕,但赤絲紅縷體征在治療前后無(wú)明顯變化(P0.05)。(2)血凝PT、PTA指標(biāo)在治療3個(gè)月與治療6個(gè)月較治療前均有明顯改善(P0.01),說(shuō)明此方案在改善凝血功能方面起到作用。治療6個(gè)月的數(shù)據(jù)與治療第3個(gè)月數(shù)據(jù)比較,凝血功能獲得進(jìn)一步改善(P0.01)。(3)治療3個(gè)月、治療6個(gè)月后患者的ALT、AST、ALB、TBIL、GGT均有改善(P0.01),證明此治療方案在改善肝功能方面效果顯著。治療6個(gè)月的數(shù)據(jù)與治療第3個(gè)月數(shù)據(jù)比較,肝功能獲得進(jìn)一步改善(P0.01)。(4)治療后肝臟超聲下門(mén)靜脈主干內(nèi)徑、脾靜脈內(nèi)徑、脾臟長(zhǎng)度、脾臟厚度均有改善,差異具有非常顯著的統(tǒng)計(jì)學(xué)意義(P0.01),說(shuō)明本方案對(duì)于降低門(mén)靜脈壓力方面有較好的療效。(5)主要不良事件:個(gè)別患者在治療過(guò)程中出現(xiàn)了多夢(mèng)、大便次數(shù)增多、皮疹癥狀,后均自行緩解,未再出現(xiàn)特殊不適。結(jié)論:(1)益氣解毒通絡(luò)方可以改善癥狀/體征、凝血功能、肝功能、腹部彩色多普勒超聲的檢測(cè)指標(biāo),說(shuō)明益氣解毒通絡(luò)方治療肝硬化門(mén)靜脈高壓癥具有臨床效果。(2)肝硬化門(mén)靜脈高壓癥患者的病情會(huì)隨著時(shí)間推移逐漸加重,需要長(zhǎng)期堅(jiān)持正確的治療方案進(jìn)行治療,對(duì)于益氣解毒通絡(luò)方治療效果的長(zhǎng)期療效也需要進(jìn)行長(zhǎng)期的隨訪。
[Abstract]:Objective: to observe the clinical effect of Yiqi jiedu Tongluo recipe in treating cirrhotic portal hypertension and compare the symptoms / signs, coagulation function and liver function before and after treatment.The changes of abdominal ultrasound were used to explore and verify the clinical effectiveness and practicability of this treatment, and to observe the adverse reactions in clinical use to evaluate its safety, and to give full play to the characteristics and advantages of traditional Chinese medicine.To provide a new idea for the clinical treatment of cirrhotic portal hypertension.Methods: the subjects were all the patients with hepatitis in Dongzhimen Hospital of Beijing University of traditional Chinese Medicine, and according with the selection criteria of this study, 34 patients were treated with Yiqi jiedu Tongluo decoction for 6 months, recorded and observed.The changes of TCM symptom score, coagulation function, liver function, portal vein diameter and splenic vein diameter were compared before and after treatment. The statistical data were analyzed by SPSS21.0 software.Results (1) after treatment, the patients suffered from pain in the rib, less food intake, fatigue, abdominal distension and hypochondriac bulge. The face of liver disease was significantly reduced than that before treatment, and the symptoms of hemorrhage were alleviated than that before treatment (P0.05).However, there was no significant change in P0.05 P0.05. 2) the blood coagulation PTT PTA index was significantly improved in 3 months and 6 months after treatment compared with that before treatment, indicating that this scheme plays an important role in improving coagulation function.Compared with the data of the 3rd month, the coagulation function was further improved for 3 months. After 6 months of treatment, the patients with ALT AST and TBILG GT all improved P0.01G GT, which proved that the treatment regimen was effective in improving liver function.Compared with the data of the 3rd month after treatment, the liver function was further improved (P0.01U. 4) after the treatment, the diameter of portal vein, the diameter of splenic vein, the length of spleen and the thickness of spleen were all improved.The difference was statistically significant (P 0.01), indicating that this regimen had a better effect on reducing portal vein pressure.) the main adverse events were: some patients had more dreams, more defecations, and rash symptoms during the course of treatment.After the relief, there was no special discomfort again.Conclusion (1) Yiqi jiedu Tongluo prescription can improve symptoms / signs, coagulation function, liver function, abdominal color Doppler ultrasound detection index.It shows that Yiqi jiedu Tongluo recipe has clinical effect in treating cirrhotic portal hypertension.The long-term effect of Yiqi-jiedu Tongluo prescription also needs long-term follow-up.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉求明;堯晨光;郭曉紅;胡康洪;;抗乙肝病毒藥物研究新進(jìn)展[J];病毒學(xué)報(bào);2016年05期

2 魏聰;賈振華;常麗萍;;中醫(yī)絡(luò)病學(xué)科研究回顧與展望[J];中醫(yī)雜志;2015年22期

3 王顯;王永炎;;對(duì)“絡(luò)脈、病絡(luò)與絡(luò)病”的思考與求證[J];北京中醫(yī)藥大學(xué)學(xué)報(bào);2015年09期

4 庾少梅;周偉青;林銳珊;蘇寧;劉坤東;;三七總皂苷對(duì)實(shí)驗(yàn)性酒精性肝硬化大鼠的保護(hù)作用研究[J];世界中西醫(yī)結(jié)合雜志;2015年06期

5 馬繼征;王少麗;白宇寧;劉震;陳蘭羽;劉紹能;姚乃禮;;肝絡(luò)與肝竇的關(guān)系探討[J];中西醫(yī)結(jié)合肝病雜志;2015年01期

6 袁媛;吳芹;石京山;陳修平;;丹參及其主要成分保肝作用的研究進(jìn)展[J];中國(guó)中藥雜志;2015年04期

7 鄭鸞鸞;韓國(guó)宏;樊代明;;經(jīng)頸靜脈肝內(nèi)門(mén)體分流術(shù)在肝硬化靜脈曲張出血防治中的地位[J];臨床肝膽病雜志;2014年07期

8 吳輝坤;李天望;;門(mén)脈高壓性胃病肝郁脾虛證與一氧化氮及內(nèi)皮素水平關(guān)系研究[J];中西醫(yī)結(jié)合肝病雜志;2014年01期

9 吳深濤;;內(nèi)毒辨釋[J];上海中醫(yī)藥雜志;2014年02期

10 鄭樹(shù)森;俞軍;張武;;肝移植在中國(guó)的發(fā)展現(xiàn)狀[J];臨床肝膽病雜志;2014年01期

，

本文編號(hào)：1722590