摘要
目的:探讨苓桂术甘汤联合前列地尔对肝硬化腹水患者的治疗效果。方法:选取2017年1月-2021年1月于本院住院的肝硬化腹水患者90例为研究对象,随机分为对照组与病例组,每组45例。对照组给予前列地尔治疗,病例组在对照组基础上给予苓桂术甘汤治疗。比较两组治疗前后的肝功能、门静脉系统血流动力学、临床症状、血清炎性因子、肾素-血管紧张素-醛固酮系统指标、脂多糖(LPS)、内皮素-1(ET-1)、一氧化氮(NO)及内毒素。结果:治疗后,两组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、门静脉内径(Dpv)、脾静脉内径(Dsv)、体重、腹围、腹水深度、白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、LPS、ET-1、NO、内毒素、肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)及醛固酮(ALD)均较治疗前降低,白蛋白(ALB)、门静脉血流速度(Vpv)、脾静脉血流速度(Vsv)、24 h尿量均较治疗前升高,且病例组均优于对照组,差异均有统计学意义(P<0.05)。病例组治疗总有效率(93.33%)高于对照组(75.56%),差异有统计学意义(P<0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:苓桂术甘汤联合前列地尔治疗肝硬化腹水患者有利于改善肝功能和门静脉系统血流动力学,降低炎症反应,减少腹水量,降低血清LPS、ET-1、NO、内毒素水平,安全性较好。
Objective:To investigate the therapeutic effect of Lingguizhugan Decoction combined with Alprostadil on patients with cirrhosis ascites.Method:A total of 90 patients with cirrhosis ascites hospitalized in our hospital from January 2017 to January 2021 were selected as the research subjects.They were randomly divided into control group and case group,with 45 cases in each group.The control group was treated with Alprostadil,and the case group was treated with Lingguizhugan Decoction on the basis of the control group.Liver function,hemodynamics of the portal vein system,clinical symptoms,serum inflammatory factors,renin-angiotensinaldosterone system indexes,lipopolysaccharide(LPS),endothelin-1(ET-1),nitric oxide(NO)and endotoxin were compared between the two groups before and after treatment.Result:After treatment,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),portal vein diameter(Dpv),splenic vein diameter(Dsv),body weight,abdominal circumference,ascites depth,interleukin(IL)-6,IL-8,tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),LPS,ET-1,NO,endotoxin,renin activity(PRA),angiotensin Ⅱ(AngⅡ)and aldosterone(ALD)decreased compared with before treatment,albumin(ALB),portal vein flow velocity(Vpv),splenic vein flow velocity(Vsv),24 h urine volume increased compared with before treatment,and those of the case group were better than the control group,the differences were statistically significant(P<0.05).The total effective rate of the case group(93.33%)was higher than that of the control group(75.56%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of ADR between the two groups(P>0.05).Conclusion:Lingguizhugan Decoction combined with Alprostadil in the treatment of patients with cirrhosis ascites is beneficial to improve liver function and hemodynamics of the portal vein system,reduce inflammatory response,reduce the amount of abdominal water,reduce serum LPS,ET-1,NO and endotoxin levels,with good safety.
作者
孔祥钢
刘斌
KONG Xianggang;LIU Bin(Chaisang District People’s Hospital,Jiujiang 332100,China;不详)
出处
《中国医学创新》
CAS
2021年第19期57-61,共5页
Medical Innovation of China
基金
中国肝炎防治基金会资助项目(TQGB20200135)。
