丹参、黄芪对肝硬化门静脉高压患者血流动力学及肝纤维化指标的影响

目的：观察丹参、黄芪对肝硬化门静脉高压血液动力学及肝纤维化指标的影响。方法：选择84例肝硬化门静脉高压患者，随机分为A（常规治疗）组42例和B（常规加丹参、黄芪治疗）组４２例，分别于治疗前、治疗１、２、３个月后监测门静脉内径（Ｄpv），脾静脉内径（Ｄsv），门静脉血流速度（Ｓpv）、脾静脉血流速度（Ｓsv），门静脉血流量（Ｑpv），脾静脉血流量（Ｑsv），及肝纤维化指标血清透明质酸（ＨＡ）、Ⅲ型前胶原肽（ＰＣⅢ）、层粘蛋白（ＬＮ）各１次，并作对比分析。结果：Ｂ组Ｄpv、Dsv缩小，Spv、Ssv加速，Qpv、Qsv减少，与Ａ组比较差异均有显著性（Ｐ＜０.０５，Ｐ＜０.０１）。且ＨＡ、ＰＣⅢ、ＬＮ有明显改善，与Ａ组比较差异也有显著性（Ｐ＜０.０１）。结论：丹参、黄芪能较好地改善肝硬化门静脉高压，作用机制之一可能与改善肝纤维化有关。

Influence of Salvia Miltiorrhizae and Astragalus membranaceus on Hemodynamics and Liver Fibrosis Indexes in Liver Cirrhotic Patients with Portal Hypertension

OBJECTIVE: To observe the influence of Salvia miltiorrhiza (SM) and Astragalus membranaceus (AM) on hemodynamics and liver fibrosis indexes in patients of liver cirrhosis with portal hypertension. METHODS: Eighty-four cases of liver cirrhosis were enrolled and divided randomly into two groups, 42 in each. The control group was treated with conventional therapy and the tested group treated with SM and AM. The parameters, including diameter of portal vein and splenic vein (Dpv and Dsv), speed of blood flow in portal vein and splenic vein (Spv and Ssv), quantity of blood flow in portal vein and splenic vein (Qpv and Qsv) as well as liver fibrosis indexes, such as HA, PC III and LN, were determined before, 1, 2 and 3 months after treatment. RESULTS: After treatment, in the tested group, Dpv and Dsv decreased, Spv and Ssv increased, and Qpv and Qsv reduced, showing a significant difference in comparison with those in the control group (P < 0.05 or P < 0.01). The liver fibrosis indexes were improved significantly in the tested group, also showed significant difference from those in the control group (P < 0.01). CONCLUSION: SM and AM could improve portal hypertension effectively in liver cirrhosis patients, one of the mechanism may be related with the improvement of liver fibrosis.