生长抑素联合丹参治疗肝硬化并发上消化道出血与门静脉血栓形成的临床研究

Clinical study of Somatostatin with Salviae in treatment of upper gastrointestinal bleeding and portal vein thrombosis in patients with liver cirrhosis

摘要:

探讨生长抑素联合丹参对肝硬化并发上消化道出血（UGB）与门静脉血栓（PVT）形成的疗效作用。方法选取2010 年1 月-2016 年1 月在华北理工大学附属医院和唐山市传染病院住院的肝硬化并发UGB 与PVT形成的患者96 例。随机分为对照组24 例，给予对症支持治疗；生长抑素组24 例，给予对症支持治疗+ 生长抑素；丹参组24 例，给予对症支持治疗+ 丹参；联合治疗组24 例，给予对症支持治疗+ 生长抑素+ 丹参。观察4 组患者治疗后丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、胆碱酯酶（CHE）、肝功能Child评分、凝血酶原时间（PT）、纤维蛋白原（FIB）、血小板（PLT）、门静脉内径（PVD）的变化及临床症状改善情况。结果生长抑素组、丹参组、联合治疗组ALT、AST、CHE、肝功能Child评分、PT、FIB、PLT、PVD 与对照组相比，差异有统计学意义（p <0.05），以联合治疗组降低最为明显；联合治疗组与生长抑素组、丹参组比较，差异有统计学意义（p <0.05）。结论联合应用生长抑素和丹参治疗肝硬化并发上消化道出血与门静脉血栓形成有较好协同作用，疗效优于单纯西药治疗。

Abstract:

To investigate the therapeutic effect of Somatostatin with Salviae in treatment of upper gas-trointestinal bleeding and portal vein thrombosis in patients with liver cirrhosis. Methods Totally 96 patients with liver cirrhosis treated in the Affiliated Hospital of North China University of Science and Technology and Tangshan City Hospital for Infectious Diseases from January 2010 to January 2016 were enrolled. They were divided into four groups, namely control group (received symptomatic and supportive treatment), Somatostatin group (received symp-tomatic and supportive treatment and Somatostatin), Salviae group (given symptomatic and supportive treatment and Salviae), and combined treatment group (accepted symptomatic and supportive treatment, Somatostatin and Salviae) with 24 cases in each group. The changes of ALT, AST, CHE, liver function Child-Pugh classification, PT, FIB,PLT, PVD and prognosis were observed after treatment. Results ALT, AST, CHE, liver function Child-Pugh classifi-cation, PT, FIB, PLT and PVD in the Somatostatin, Salviae and combined treatment groups were significantly differ-ent from those in the control group (p < 0.05); the reduction was most obvious in the combined treatment group. The indexes of the combined treatment group were significantly different from those of the Somatostatin and Salviae groups (p < 0.05). Conclusions Combination of Somatostatin and Salviae has better synergistic therapeutic effect in the treatment of upper gastrointestinal bleeding and portal vein thrombosis in patients with liver cirrhosis, which is superior to using western medicine alone.