丹参等活血化淤中药对门脉高压血流动力学影响的临床与实验研究

目的探讨丹参、当归等及硝苯啶对门脉高压血流动力学的影响。方法采用血管插管测定胆管结扎肝硬化犬门脉系统压力变化；超声多普勒观测肝硬化患者门脉血流动力学变化。结果（１）静脉滴注丹参、当归后，肝硬化犬门静脉压（Ｐｐｖ）、嵌塞肝静脉压（ＷＨＶＰ）、肝静脉压力梯度（ＨＶＰＧ）显著降低（Ｐ＜０．０５～０．０１），平均动脉压（ＭＡＰ）、心率（ＨＲ）无明显变化（Ｐ＞０．０５），硝苯啶则使Ｐｐｖ，ＷＨＶＰ，ＭＡＰ．ＨＲ显著降低（Ｐ＜０．０５）。（２）丹参、丹参＋硝苯啶．丹参＋水＋硝苯啶口服药１０－１２周，能显著降低肝硬化患者门静脉内径（Ｄｐｖ）、脾静脉内径（Ｄｓｖ）．门静脉血流量（Ｑｐｖ），脾静脉血流量（Ｑｓｖ）（Ｐ＜０．０５－０．０１，当归作用较弱。结论对比表明，丹参、当归等中药较硝苯啶对门脉压力作用为慢，但较持久，无副反应。

Clinical and experimental study of radix salviae miltiorrhiza and other Chinese herbs of blood-activating and stasis-eliminating effects on hemodynamics of portal hypertension

Objectives To study the effects of Radix Salviae Militiorrhiza and other Chinese herbs of blood-activating and stasis-eliminating on hemodynamics of portal hypertension. Methods Portal pressure of cirrhotic dogs after chronic common bile duct ligation was measured directly; Portal. blood flow in patients with cirrhosis was detected by Ultrasound Doppler. Results (1) after administration of RSM and RAS by intravenous infusion in cirrhotic dogs , the portal venous pressure (Ppv), wedged hepatic venous. pressure (WHVP), hepatic venous pressure gradient (HVPG) were significantly decreased (P<0.05.-.0.01), but the mean arterial pressure (MAP), the heart rate (HR) were unchanged: when nifedipine was used, Ppv, WHVP, MAP, HR were significantly decreased (P< 0,05), but the HVPG was unchanged (P> 0.05). (2) In patients with hepatic cirrhosis and portal hypertension, after administration of RSM, RSM nifedipine, RSM . Hirudin .nifedipine (10-12week), the diameter of portal vein (Dpv) and splenic vein (Dsv), the portal venous flow (Qpv), splenic venous flow (Qsv) in patients with hepatic cirrhosis were significantly decreased, respectively (P<0.05-0.01), the effect of RAS was weaker. Con- clusions The efficacy of decreasing Ppv by Chinese herbs-RSM and RAS etc. as compared with nifedipine, demonstrated that Chinese herbs were slower in action than that of nifedipine, but more long-lasting, and without side effects. Hence, long term administration of Chinese herbs, would be more beneficial.