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[目的]探讨复方丹参滴丸与普萘洛尔联用对肝硬化门脉高压食管静脉曲张破裂出血(EVB)的预防作用。[方法]选择肝硬化门脉高压患者100例,随机分为常规治疗(Ⅰ)组,普萘洛尔加常规治疗(Ⅱ)组,复方丹参滴丸加常规治疗(Ⅲ)组及普萘洛尔与复方丹参滴丸联用加常规治疗(Ⅳ)组,每组25例。应用彩色多普勒超声测定4组患者治疗前、治疗后3个月门静脉内径(Dpv),脾静脉内径(Dsv),门静脉血流速度(Spv),脾静脉血流速度(Ssv),并计算门静脉血流量(Qpv),脾静脉血流量(Qsv)。随访1年,动态观察血压、心率、肝肾功能及EVB复发情况。[结果]用药后,Ⅱ、Ⅲ、Ⅳ组Dpv、Dsv均较Ⅰ组减小(P<0.01,<0.05),DsvⅣ组与Ⅱ、Ⅲ组比较均减小更明显(P<0.05)。Dpv,DsvⅡ、Ⅲ组比较差异无统计学意义。Ⅱ、Ⅲ、Ⅳ组Qpv、Qsv显著降低(P<0.05,<0.01)。Ⅳ组上消化道出血的发生率明显降低(P<0.05)。[结论]复方丹参滴丸与普萘洛尔联用治疗肝硬化门脉高压症,预防EVB效果优于复方丹参滴丸或普萘洛尔。复方丹参滴丸与普萘洛尔组效果比较无明显差异。
[Objective] To investigate the preventive effect of compound Danshen dripping pills combined with propranolol on patients with cirrhosis and portal hypertension with esophageal variceal bleeding (EVB). [Methods] One hundred patients with cirrhotic portal hypertension were randomly divided into two groups: conventional treatment (Ⅰ), propranolol plus conventional treatment (Ⅱ), compound Danshen dropping pills plus conventional treatment (Ⅲ) and propranolol Er and Danshen dripping pills combined with conventional treatment (Ⅳ) group, 25 cases in each group. The Dpv, Dsv, Spv and Ssv of the four groups were measured before and 3 months after treatment with color Doppler sonography. Portal vein blood flow (Qpv), splenic vein blood flow (Qsv). One year follow-up, blood pressure, heart rate, liver and kidney function and EVB recurrence were observed dynamically. [Results] After treatment, the Dpv and Dsv in group Ⅱ, Ⅲ and Ⅳ decreased compared with that in group Ⅰ (P <0.01, <0.05), and decreased significantly in group DsvⅣ and group Ⅱ and Ⅲ (P <0.05). There was no significant difference between Dpv, DsvⅡ and Ⅲ groups. Qpv and Qsv in group Ⅱ, Ⅲ and Ⅳ decreased significantly (P <0.05, <0.01). The incidence of upper gastrointestinal bleeding was significantly lower in group Ⅳ (P <0.05). [Conclusion] Compound Danshen dripping pills combined with propranolol in the treatment of liver cirrhosis and portal hypertension is superior to compound Danshen dripping pills or propranolol in preventing EVB. Compound Danshen dripping pills and propranolol group no significant difference in the effect.