Effect of traditional Chinese medicine on portal vein thrombosis in patients with liver cirrhosis and its medication characteristics
10.3969/j.issn.1001-5256.2023.02.014
- VernacularTitle:中医药对肝硬化门静脉血栓的干预作用及用药特点分析
- Author:
Yanan GUO
1
,
2
;
Hongtu GU
1
,
2
,
3
;
Changqing ZHAO
1
,
2
,
3
;
Yongping MU
1
,
2
,
3
;
Jili YUAN
1
,
2
,
3
;
Feng XING
1
,
2
,
3
;
Yanyan TAO
1
,
2
,
3
;
Jing LYU
1
,
2
,
3
;
Chenghai LIU
1
,
2
,
3
,
4
Author Information
1. Second Department of Hepatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine
2. Institute of Liver Diseases, Shanghai Institute of Traditional Chinese Medicine, Shanghai 201203, China
3. Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, China
4. Key Laboratory of Liver and Kidney Diseases, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Publication Type:Original Article_Liver Fibrosis and Liver Cirrhosis
- Keywords:
Liver Cirrhosis;
Portal Vein Thrombosis;
Pathogenests (TCM)
- From:
Journal of Clinical Hepatology
2023;39(2):345-351
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the therapeutic effect of traditional Chinese medicine (TCM) on portal vein thrombosis (PVT) in patients with liver cirrhosis and its medication characteristics. Methods A retrospective analysis was performed for 89 patients with liver cirrhosis and PVT who were hospitalized and treated in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and according to whether TCM treatment was applied in combination, they were divided into TCM group with 59 patients and control group with 30 patients. Related data were collected for the two groups, including demographic data, laboratory examination, radiological examination, gastroscopy, history of surgery, portal hypertension-related complications, medication, and follow-up data. The independent samples t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. An ordinal polytomous Logistic regression analysis was used for multivariate analysis. TCM Inheritance Computing Platform (V3.0) was used to perform a drug effect cluster analysis of TCM prescriptions. Results The multivariate logistic regression analysis showed that esophageal and gastric varices (odds ratio [ OR ]=3.144, 95% confidence interval [ CI ]: 1.221-8.094), PVT involving the portal vein (PV) and the superior mesenteric vein (SMV) ( OR =51.667, 95% CI : 3.536-754.859), PVT involving PV+spleen vein (SV)+SMV ( OR =13.271, 95% CI : 2.290-76.928), cavernous transformation of the portal vein ( OR =11.896, 95% CI : 1.172-120.696), and TCM intervention ( OR =0.348, 95% CI : 0.129-0.938) were influencing factors for the outcome of PVT in liver cirrhosis. Follow-up results showed that compared with the control group, the TCM group had a significantly lower progression rate (16.95% vs 56.67%, P < 0.001) and a significantly lower incidence rate of variceal rupture and bleeding (8.47% vs 33.33%, P < 0.001). Effective TCM drugs with a relatively high frequency of use included deficiency-tonifying drugs (359 times, 34.6%), blood-activating and stasis-resolving drugs (202 times, 19.5%), and diuresis-inducing and dampness-draining drugs (180 times, 17.3%); the TCM drugs with a relatively high frequency of use included Astragalus membranaceus (57 times, 8.7%), Angelica sinensis (50 times, 7.6%), and leech (48 times, 7.3%); TCM drug combinations with a relatively high frequency of use included Astragalus membranaceus+Angelica sinensis, Astragalus membranaceus+leech, Angelica sinensis+leech, and Astragalus membranaceus+Angelica sinensis+leech. Conclusion Qi-tonifying, blood-activating, and stasis-breaking drugs, such as Astragalus membranaceus, Angelica sinensis, and leech, can promote the stabilization or recanalization of PVT in liver cirrhosis and reduce the incidence rate of bleeding events due to portal hypertension.
