复元活血汤对瘀血阻络型肝硬化脾功能亢进患者脾动脉栓塞术后综合征的干预疗效

Intervention Effect of Fuyuan Huoxuetang for Postoperative Syndrome of Partial Splenic Arterial Embolization in Patients with Hypersplenism of Blood Stasis Type Liver Cirrhosis

目的:分析复元活血汤对瘀血阻络型乙型肝炎肝硬化脾功能亢进患者脾动脉栓塞(PSE)术后综合征的干预效应。方法:选择86例瘀血阻络型肝硬化脾功能亢进PSE术后患者进行观察,其中观察组44例,对照组42例。观察组及对照组均给予常规护肝、抗病毒、术后预防性抗感染及对症支持治疗,观察组于PSE术后第1天开始口服复元活血汤。观察两组患者术后7d的疼痛程度评分、发热持续时间、腹胀便秘程度及生化指标改变。结果:与本组治疗前比较,两组患者PSE术后经治疗,γ-谷氨酰转肽酶(GGT),白细胞(WBC)水平均明显升高(P<0.05),白蛋白(ALB)均明显下降(P<0.05);手术前后丙氨酸氨基转移酶(ALT),天冬氨酸氨基转移酶(AST)平稳,无肝衰竭征象,ALT及AST无显著改变;观察组患者术后经口服复元活血汤治疗后,WBC水平明显高于对照组(P<0.05);与对照组比较,观察组患者疼痛程度评分明显低于对照组(P<0.05),而且发热持续时间明显短于对照组(P<0.05);腹胀便秘缓解总有效率优于对照组(P<0.05),且整个治疗过程中无明显不良反应,安全性良好。结论:复元活血汤可通过减轻患者疼痛、缩短发热持续时间及缓解腹胀便秘程度而有效干预PSE术后综合征。

Objective: To analyze the effect of Fuyuan Huoxuetang for the postoperative syndrome of partial splenic arterial embolization(PSE) in patients with hypersplenism of blood stasis type hepatic cirrhosis.Method: 86 patients with hypersplenism of blood stasis type hepatic cirrhosis treated with PSE were divided into observation group(44 cases) and control group(42 cases). Patients in both groups were treated with routine liver protection, antiviral, postoperative prophylactic anti-infection and symptomatic supportive care. Patients in treatment group started to take the Fuyuan Huoxuetang on the first day after the operation of PSE. The degree of pain,duration of fever,abdominal distention,and biochemical index changes of the two groups were observed 7 days after surgery. Result: After postoperative treatment,both groups of patients showed significant increases in the levels of-glutamyl transpeptidase(GGT) and white blood cell(WBC)(P < 0. 05),and significant decreases in albumin(ALB)(P < 0. 05). After surgery,alanine aminotransferase(ALT) and aspartate aminotransferase(AST) levels were stable,with no significant changes and no signs of liver failure. The WBC level of patients in observation group was significantly higher than that of control group(P < 0. 05) after the treatment with oral Fuyuan Huoxuetang. As compared with control group,the pain score was significantly lower in observation group(P <0. 05);the duration of fever was significantly shorter(P < 0. 05);the total effective rate of relieving abdominal distension constipation was higher(P < 0. 05),and there was no obvious adverse reaction during the whole treatment process,with good safety in observation group. Conclusion: Fuyuan Huoxuetang could effectively interfere with the postoperative syndrome of PSE in patients with hepatic cirrhosis combined with hypersplenism by reducing pain,shortening the duration of fever and relieving the degree of abdominal distension and constipation.