肝硬化患者凝血系统功能异常中医用药规律分析及病机探讨

Medication rule analysic and pathogenic characteristics exploration of coagulation system dysfunction in patients with liver cirrhosis in terms of TCM

目的分析中医药干预并改善肝硬化患者凝血系统功能异常的文献报道,总结常用的治则和方药,探索肝硬化患者凝血系统功能异常的中医病机特点,为治疗肝硬化患者凝血系统功能异常提供依据。方法以"肝硬化"和"凝血"和"中医""肝硬变"和"凝血"和"中医"进行全文检索,系统检索了中国知网、万方数据知识服务平台、中文维普科技期刊数据库的期刊文献。选取符合要求的文献,建立Excel工作表,根据文章内容进行分类,分别提取相关内容。最后,对所提取的内容进行分析、归纳、总结。结果 19篇干预研究可为中医药干预能够改善凝血系统功能障碍提供证据,所检测的反映凝血系统功能的指标包括PT、APTT、TT、FIB,治则以活血化瘀/软肝散结、健脾/益气应用最多,常用的具有活血化瘀/软肝散结的中药有丹参、鳖甲、当归等,具有益气健脾作用的中药以黄芪、白术最为常用。结论瘀血、(脾)气虚是肝硬化患者凝血系统功能异常的主要病理机制,通过活血化瘀、健脾益气可以使肝硬化患者凝血系统功能异常得到改善。

Objective This article is to analyze the literature report related to Chinese medicine intervention and its effect on coagulation system dysfunction in patients with liver cirrhosis, to summarize the common treatments and prescriptions, and to explore the pathogenic characteristics of coagulation system dysfunction in liver cirrhosis from the perspective of TCM, so as to provide a basis for the treatment of coagulation system dysfunction in liver cirrhosis. Method Do full text research in China National Knowledge Intemet, Wanfang Data Knowledge Service Platform, and VIP Chinese science and technology pe- riodical database with the keywords ＂liver cirrhosis＂ and ＂coagulation＂ and ＂TCM＂, ＂hepatocirrhosis＂ and ＂coagulation＂ and ＂TCM＂ to get periodical literature. Select the satisfactory literature, constract an excel worksheet, then classify them ac- cording to the content and extract the relevant content respectively. Finally, analyze, generalize and summarize the extracted content. Results 19 intervention studies have proved that Chinese medicine intervention can improve coagulation system dysfunction in patients with liver cirrhosis. In these studies, indexes reflecting coagulation system function include P-F, ~, TY and FIB. The main treatments include activating blood and dissolving stasis, softening the liver and eliminating stagnation, and strengthening the spleen and replenishing Qi. The commonly used Chinese herbs to activate blood and dis- solve stasis, soften the hver and ehminate stagnation are the root of red-rooted salvia, turtle shell, angelica sinensis, etc. The commonly used Chinese herbs to strengthen the spleen and replenish Qi are astragalus zome, etc. Conclusion Blood stasis and （Spleen） Qi deficiency are the main pa mongholicus, bighead atractylodes rhi- esis of coagulation system dysfunction in patients with liver cirrhosis. Activating blood and dissolving stasis, strengthening the spleen and replenishing Qi can im-prove coagulation system dysfunction in patients with liver cirrhosis.