肝脾疏络饮联合西医治疗肝衰竭的B超下病理改变

Pathological changes under B-ultrasound of Ganpi Shuluo Decoction combined with western medicine in the treatment of liver failure

目的 观察肝脾疏络饮联合西医治疗肝衰竭患者彩色B超下肝脏的改善情况。方法 收集眉山市中医医院2012年9月～2013年9月收治的28例确诊肝衰竭患者，随机分为西医组和中西医结合组，两组在常规治疗的基础上联合人工肝治疗，中西医结合组在上述治疗的基础加用肝脾疏络饮。观察两组治疗前后彩色B超显示的肝脏变化。结果 西医组治疗4周肝包膜、实质回声与治疗前比较，差异无统计学意义（P〉0．05）；中西医结合组治疗4周肝包膜、实质回声与治疗前比较，差异无统计学意义（P〉0．05）。治疗4周时西医组与中西医结合组肝包膜、实质回声比较，差异无统计学意义（P〉0．05）。西医组治疗8周肝包膜、实质回声与治疗前比较，差异无统计学意义（P〉0．05）；中西医结合组治疗8周肝包膜与治疗前比较，差异有统计学意义（P=0．045），实质回声与治疗前比较，差异无统计学意义（P〉0．05）。治疗8周时中西医结合组与西医组肝包膜比较，差异有统计学意义（P=0．031），两组实质回声比较，差异无统计学意义（P〉0．05）。与治疗前比较，中西医结合组治疗第8周门静脉主干直径、脾静脉宽度及脾厚度差异有统计学意义（t=2．23、2．15、1．95，均P〈0．05）。两组治疗8周后门静脉主干直径及脾静脉宽度比较差异有统计学意义（t=2．27、2．25，均P〈0．05），脾厚度变化两组间比较差异无统计学意义（t=0．39，P〉0．05）。结论 通过B超初探肝脾疏络饮联合西医治疗对肝衰竭患者的肝脏及相关病理改变有一定的改善作用。

Objective To observe the improvement of liver of Ganpi Shuluo Decoction combined with western medicine in the treatment of patients with liver failure under B-ultrasound. Methods 28 cases of patients with liver failure admitted to Meishan TCM Hospital from September 2012 to September 2013 were collected and randomly assigned to the western medicine group and integrative group. Both groups were given the treatment of artificial liver on basis of rou- tine treatment, while patients in the integrative group were added with Ganpi Shuluo Decoction. Liver changes showed by color B ultrasound before and after treatment were observed. Results The Glisson capsule, parenehyma echo after treatment for 4 weeks in the western medicine group had no significant differences compared with before treatment （P 〉 0.05）; the Glisson capsule, parenchyma echo after treatment for 4 weeks in the integrative group had no significant differences compared with before treatment （P 〉 0.05）; the Glisson capsule, parenchyma echo after treatment for 4 weeks between the western medicine group and the integrative group had no significant differences （P 〉 0.05）. The Glisson capsule, parenchyma echo after treatment for 8 weeks in the western medicine group had no significant differences compared with before treatment （P 〉 0.05）; the Glisson capsule after treatment for 8 weeks in the integrative group had a significant difference compared with before treatment （P = 0.045）, which of parenchyma echo had no significant difference compared with before treatment （P 〉 0.05）; the Glisson capsule after treatment for 8 weeks between the western medicine group and the integrative group had significant difference （P = 0.031）, which of parenchyma echo had no significant difference （P 〉 0.05）. Compared with before treatment, the improvement of the diameter of main portal vein, the width of the splenic vein, splenic thickness after treatment for 8 weeks in the integrative group had significant differences （t = 2.23, 2.15, 1.95, all P 〈 0.05）. After treatment for 8 weeks, the diameter of main portal vein, the width of the splenic vein between the two groups had significant differences （t = 2.27, 2.25, all P 〈 0.05）, while that of splenic thickness had no significant difference （t = 0.39, P 〉 0.05）. Conclusion The examination of liver and its related pathological changes of Ganpi Shuluo Decoction combined with western medicine in the treatment of patients with liver failure through B-ultrasound has some effects.