肝硬化门静脉高压症的药物治疗

Medicinal treatment of portal hypertension in liver cirrhosis

门静脉高压是肝硬化恶化的关键病理生理基础,可导致食管胃底静脉曲张破裂出血、难治性腹水及肝性脑病等多种并发症。药物治疗是肝硬化门静脉高压症的基础与主要治疗方法,根据门静脉高压病理形成机制,药物治疗主要包括病因治疗、抗肝纤维化降低肝内阻力、缩血管活性药物减少门静脉血流等多种治疗措施。临床实践中,应根据肝硬化门静脉高压症的不同阶段与临床表现,合理选择药物或药物+内镜下干预等联合方法,中医药抗肝纤维化及其病证结合治疗在门静脉高压症的防治过程中具有重要意义。

Portal hypertension is the key pathophysiological basis for the deterioration of liver cirrhosis,which can lead to multiple complications such as esophageal and gastric varices bleeding,refractory ascites,and hepatic encephalopathy,etc.Medicinal treatment is the basis and main method for the treatment of portal hypertension due to liver cirrhosis.According to the pathological mechanism of portal hypertension,the treatment strategies of medicines or drugs include etiological therapy,anti-liver fibrotic agents to reduce intrahepatic resistance,and vasoconstrictors to reduce portal blood flow,etc.In clinical practice,according to the different stages and clinical manifestations of portal hypertension in liver cirrhosis,drugs should be reasonably selected,or combined such as endoscopic intervention combined with drugs.The anti-fibrotic traditional Chinese medicines and the therapies based on the combination of disease and syndrome are of great significance in the prevention and treatment of portal hypertension.