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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 10
Oct.  2018
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Effect of spleen-strengthening, dampness-removing, and hemostatic prescription on rebleeding within one year in cirrhotic patients with esophagogastric variceal bleeding

DOI: 10.3969/j.issn.1001-5256.2018.10.015
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  • Published Date: 2018-10-20
  • Objective To investigate the effect of spleen-strengthening, dampness-removing, and hemostatic prescription on rebleeding within one year in cirrhotic patients with esophagogastric variceal bleeding ( EGVB) . Methods A total of 750 cirrhotic patients with EGVB who were admitted to Beijing Ditan Hospital, Capital Medical University, from August 2008 to October 2016 were enrolled and followed up for one year. According to cumulative defined daily dose ( cDDD) , these patients were divided into traditional Chinese medicine ( TCM) group with 276 patients ( the dose of spleen-strengthening, dampness-removing, and hemostatic prescription ≥28 cDDD) and n* on-TCM group with 474 patients ( the dose of TCM < 28 cDDD) . The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test was used for comparison of categorical data between groups. A multivariate logistic regression analysis was used to determine the influencing factors for EGVB rebleeding. Results The presence or absence of the treatment with spleen-strengthening, dampness-removing, and hemostatic prescription was one of the independent risk factors for rebleeding within one year in cirrhotic patients with EGVB ( odds ratio = 0. 076, 95% confidence interval: 0. 039-0. 126, P = 0. 002) . The TCM group had a significantly lower incidence rate of rebleeding within one year than the non-TCM group ( 43. 5% vs 55. 1%, χ2= 4. 246, P = 0. 025) . The median time of rebleeding was 95 days in the TCM group and 121 days in the non-TCM group, and there was a significant difference between the two groups ( Z = 1. 981, P = 0. 003) . Conclusion Spleen-strengthening, dampness-removing, and hemostatic prescription can reduce the risk of rebleeding within one year in cirrhotic patients with EGVB and shorten the time of rebleeding.

     

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  • [1]HOLSTER IL, TJWA ET, MOELKER A, et al.Covered transjugular intrahepatic portosystemic shunt versus endoscopic therapy+β-blocker for prevention of variceal rebleeding[J].Hepatology, 2016, 63 (2) :581-589.
    [2]Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Gastroenterology, Chinese Medical Association;Chinese Society of Endoscopy, Chinese Medical Association.Guidelines for the diagnosis and treatment of esophageal and gastric variceal bleeding in cirrhotic portal hypertension[J].J Clin Hepatol, 2016, 32 (2) :203-219. (in Chinese) 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会内镜学分会.肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J].临床肝胆病杂志, 2016, 32 (2) :203-219.
    [3]de FRANCHIS R;Baveno V Faculty.Revising consensus in portal hypertension:Report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension[J].J Hepatol, 2010, 53 (4) :762-768.
    [4]XIAO DH, GU J, CAI H, et al.A randomized placebo-controlled multicentre study of Fuzhenghuayu capsule for prevention of oesophageal variceal bleeding in patients with liver cirrhosis[J].Chin JHepatol, 2014, 22 (8) :594-599. (in Chinese) 肖定洪, 顾杰, 蔡虹, 等.扶正化瘀胶囊预防肝硬化患者食管静脉曲张破裂出血的随机对照多中心临床研究[J].中华肝脏病杂志, 2014, 22 (8) :594-599.
    [5]GU J, ZHOU Y, HONG JH, et al.Effects of Fuzheng Huayu Decoction on elevated portal pressure in rat model of dimethylnitrosamine-induced liver cirrhosis[J].World Chin J Dig, 2008, 16 (10) :1042-1046. (in Chinese) 顾杰, 周扬, 洪嘉禾, 等.扶正化瘀方对DMN肝硬化模型大鼠门静脉压力的影响[J].世界华人消化杂志, 2008, 16 (10) :1042-1046.
    [6]GU J, ZHANG Q, XUE D, et al.A randomized controlled study of fuzheng huayu capsule for prevention of esophageal variceal bleeding in patients with liver cirrhosis[J].Evid Based Complement Alternat Med, 2013, 2013:534960.
    [7]LIU C, JIANG CM, LIU CH, et al.Effect of Fuzhenghuayu decoction on vascular endothelial growth factor secretion in hepatic stellate cells[J].Hepatobiliary Pancreat Dis Int, 2002, 1 (2) :207-210.
    [8] ZHANG B.Therapeutic effect observation on prevention of cirrhosis esophageal varicose varicose vein rupture with compound strychnine soft liver tablets combined with propranolol[J].China Health Nutrition, 2014, 24 (7) :4248-4249. (in Chinese) 张博.复方鳖甲软肝片联合普萘洛尔预防肝硬化食管胃底静脉曲张破裂出血的疗效观察[J].中国保健营养, 2014, 24 (7) :4248-4249.
    [9] ZHOU ZY.Chinese medicine internal medicine[M].Beijing:China Press of Traditional Chinese Medicine, 2006:386. (in Chinese) 周仲瑛.中医内科学[M].中国中医药出版社, 2006:386.
    [10] CHEN HZ.Practical internal medicine[M].Beijing:People's Medical Publishing House, 2001:1850. (in Chinese) 陈灏珠.实用内科学[M].北京:人民卫生出版社, 2001:1850.
    [11]World Gastroenterology Organisation Global Guideline:Esophageal varices[EB/OL].http://www.worldgastroenterology.org/guidelines/global-guidelines/esophageal-varices/esophageal-varices-english.
    [12]GARCIA-TSAO G, SANYAL AJ, GRACE ND, et al.Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis[J].Hepatology, 2007, 46 (3) :922-938.
    [13]de FRANCHIS R.Evolving consensus in portal hypertension.Report of the Baveno IV consensus workshop on methodology of diagnosis and therapy in portal hypertension[J].J Hepatol, 2005, 43 (1) :167-176.
    [14]ZHU LC, WEN ZF, XU L, et al.Analysis of recurrent hemorrhage and its prognostic index within 1 year of cirrhosis of the gastroesophageal varicose vein[J].Guangdong Med J, 2012, 33 (16) :2441-2444. (in Chinese) 朱龙川, 文卓夫, 徐龙, 等.肝硬化胃食管静脉曲张1年内再出血及其预测指标分析[J].广东医学, 2012, 33 (16) :2441-2444.
    [15]GU C, LI L, WANG J, et al.Study on efficacy of endoscopic ligation therapy for esophageal varices and risk factors for postoperative rebleeding[J].J Clin Hepatol, 2014, 30 (12) :1279-1282. (in Chinese) 古川, 李璐, 王军, 等.内镜下套扎术治疗肝硬化食管静脉曲张的疗效及术后再出血的危险因素分析[J].临床肝胆病杂志, 2014, 30 (12) :1279-1282.
    [16]LIU Y.Clinical study and TCM syndromes analysis of combined Chinese and Western medicine treatment of cirrhosis associated with intestinal dysfunction[D].Beijing:Beijing Univ Tradit Chin Med, 2014. (in Chinese) 刘洋.肝硬化伴肠功能障碍中西医结合治疗的临床研究及中医证候分析[D].北京:北京中医药大学, 2014.
    [17]YANG TY.Effect of spleen humidification and detoxification on the model of acute liver failure induced by TAA[D].Beijing:Beijing Univ Tradit Chin Med, 2013. (in Chinese) 杨天翼.健脾化湿解毒方对TAA诱导的急性肝衰竭小鼠模型的影响[D].北京:北京中医药大学, 2013.
    [18]YANG Q, FENG YY, JIANG SL.Experiences of professor Yao Xixian in treating chronic hepatic fibrosis based on blood stasis theory[J].China J Tradit Chin Med Pharma, 2007, 22 (3) :168-171. (in Chinese) 杨倩, 冯玉彦, 蒋树林.姚希贤瘀血论治慢性肝纤维化经验[J].中华中医药杂志, 2007, 22 (3) :168-171.
    [19]SHEN Z, WANG F.Yin Changjian's experience in treating liver fibrosis of chronic liver disease[J].Shandong J Tradit Chin Med, 2011, 30 (4) :264-266. (in Chinese) 神州, 王芳.尹常健治疗慢性肝病肝纤维化经验[J].山东中医杂志, 2011, 30 (4) :264-266.
    [20]HAO JM, CHEN XN, YUAN C, et al.Professor Yang Zhen's experience in differentiating liver fibrosis from chronic liver disease[J].Chin J Integr Tradit West Med Liver Dis, 2013, 23 (1) :52-54. (in Chinese) 郝建梅, 陈香妮, 袁超, 等.杨震教授分型辨治慢性肝病肝纤维化的经验[J].中西医结合肝病杂志, 2013, 23 (1) :52-54.
    [21]WANG WG, CI MM, ZHANG JH, et al.Atractylodes macrocephala Koidz on gastrointestinal trace and ICC in rat with slow transit constipation[J].J Changchun Univ Chin Med, 2016, 32 (1) :18-21. (in Chinese) 王文革, 次苗苗, 张俊红, 等.不同剂量生白术对慢传输型便秘大鼠胃肠道传输功能及Cajal间质细胞的影响[J].长春中医药大学学报, 2016, 32 (1) :18-21.
    [22]LEI CH, LIN YF.Effect of warming kidney and invigorating spleen prescription on intestinal flora in patients with spleen-kidney yang deficiency[J].Clin J Med Offic, 2018, 46 (6) :642-645. (in Chinese) 雷春红, 林一帆.温肾健脾方对脾肾阳虚型结肠息肉患者肠道菌群影响[J].临床军医杂志, 2018, 46 (6) :642-645.
    [23]BOSE S, HAN KW, LEE MJ, et al.Intestinal protective effects of herbal-based formulations in rats against neomycin insult[J].Evid Based Complement Alternat Med, 2013, 2013:161278.
    [24]CAO M, WANG P, SUN C, et al.Amelioration of IFN-γand TNF-α-induced intestinal epithelial barrier dysfunction by berberine via suppression of MLCK-MLC phosphorylation signaling pathway[J].PLo S One, 2013, 8 (5) :e61944.
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