前列地尔联合补阳还五汤治疗门静脉血栓症的疗效观察

摘要

目的 观察前列地尔联合中药补阳还五汤治疗肝硬化伴门静脉血栓形成的疗效.方法 将32例患者随机分为治疗组15例,常规治疗外加用前列地尔10 μg/d静滴以及中药协定方补阳还五汤,对照组17例仅予以常规治疗,疗程1月,观察治疗前后血小板计数(PLT)、凝血酶原时间(PT)、国际标准化比值(INR)、抗凝血酶Ⅲ(ATⅢ)、D-二聚体(DDT)以及门脉血栓Yerdel的分级等指标.结果 治疗组治疗后有5例出现血栓程度及范围的改善,对照组仅有1例出现了血栓改善.与对照组比较,治疗组治疗后血小板计数降低(P＜0.05),对照组治疗前后血小板计数差异无统计学意义(P＞0.05),两组治疗后血小板计数差异有统计学意义(P＜0.05).两组患者治疗前后PT、INR比较差异无统计学意义,治疗后治疗组ATⅢ升高,与治疗前比较以及与对照组治疗后比较差异均有统计学意义(P＜0.05),对照组治疗前后ATⅢ比较差异无统计学意义(P＞0.05).两组患者治疗前DDT比较差异无统计学意义,治疗后治疗组DDT降低,与治疗前比较以及与对照组治疗后比较差异均有统计学意义(P＜0.05).结论 前列地尔联合中药补阳还五汤是一种安全有效的防治门静脉血栓形成的方案,对体内凝血、抗凝等指标有一定的影响,可以为肝硬化门静脉血栓的防治提供一种新的选择.%Objective:To observe the effect of Alprostadil combined with traditional Chinese medicine Buyang huanwu decoction in the treatment on liver cirrhosis with portal vein thrombosis.Methods:32 cases with liver cirrhosis in PVT patients were selected as object,and divided into the treatment group (15 cases) and the control group (17 cases).The tent group received routine treatment plus intravenous infusion of alprostadil 10 μg/d com bined with traditional Chinese medicine Buyang huanwu decoction.The control group only received routine treatment.The treatment lasted for one month.Before and after treatment,Platelet count (PLT),prothrombin time (PT),international normalized ratio (INR),antithrombin Ⅲ (ATⅢ),D-Dimer (DDT) and Yerdel grading of portal vein thrombosis and other indicators were observed.Results:There were 5 cases getting an improvement in Yerdel grading,but there was only 1 case in the control group.Compared with the control group,the platelet count de creased in the treatment group (P ＜ 0.05).The platelet count in the control group before and after treatment showed no statistical significance.There was significant difference in platelet count after treatment between the two groups (P ＜ 0.05).But there was no statistically significance in PT and INR between the two groups.After treatment,AT Ⅲ increased in the treatment group,compared with before treatment and compared with the control group,and the differences were statistically significant (P＜ 0.05).However,compared with the AT Ⅲ lever before and after treatment in the control group,the difference was not statistically significant.There was no significant difference in DDT before treatment between the two groups.After treatment,DDT decreased in the treatment group.Compared with before treatment and compared with the control group,the differences were statistically sig nificant (P＜ 0.05).Conclusion:Alprostadil combined with traditional Chinese medicine Buyang huanwu decoction is a safe and effective measure which has certain influence on the coagulation,anticoagulation and other indicators,and can provide a new choice for the prevention and the treatment of portal vein thrombosis in patients with cirrhosis.