The clinical characteristics of patients with porto-sinusoidal vascular disorder and applications of traditional Chinese medicine
Objective:To investigate the clinical characteristics and treatment with traditional Chinese medicine(TCM)for patients with porto-sinusoidal vascular disorder(PSVD).Methods:We retrospectively observed pa-tients with PSVD diagnosed by liver biopsy at our hospital between January 2016 and December 2023,collected their data including clinical manifestations,serological and image findings at the time of liver biopsy.Patients were divided into two groups:portal hypertension(PH)and non-PH group.The clinical features,pathological characteristics and TCM applications in PSVD patients were analyzed,and the differences between PH and non-PH subgroups in PSVD were compared.Results:A total of 47 patients were included in the study.Their liver function,renal function,and coagulation function were within normal ranges.However,60％of the patients had lower level of platelet counts than 150×109/L.60％of the patients had chronic liver diseases,and the most com-mon clinical manifestation was splenomegaly(89.36％).Histopathologically,periportal abnormalities were most frequently observed(80.85％).Stratified analysis based on the portal hypertension revealed that the PH group had significantly lower red blood cell counts,hemoglobin levels,and albumin levels,while D-dimer levels were signifi-cantly elevated.The proportion of hepatic non-zonal sinusoidal dilatation(NSD)and obliterative portal venopathy(OPV)were higher in the PH group.TCM prescription analysis indicated that the spleen-strengthening and qi-in-vigorating herbs such as Astragalus,Atractylodes,Codonopsis,and blood-activating and stasis-resolving herbs in-cluding Salvia miltiorrhiza,Paeonia rubra,Angelica sinensis were frequently used.But PSVD patients with non-PH took more herbs with qi tonification and spleen strengthening along with activating circulation,ones with PH took more herbs with spleen and kidney tonification and dissipating blood stasis.Conclusion:PVSD is commonly coexisted in patients of chronic liver diseases with identified etiologies,characterized by thrombocytopenia,spleno-megaly,and periportal abnormalities in liver tissue.PSVD patients with PH have more severe OPV and a higher proportion of NSD.TCM treatment primarily involves qi tonification and spleen strengthening along with activa-ting circulation.As for PSVD with PH,additional use of herbs with functions of tonifying liver and kidney and ac-tivating blood stasis may be beneficial.
porto-sinusoidal vascular disorderportal hypertensiontraditional Chinese medicineblood-acti-vating and stasis-resolvingmedication usage characteristics
NETL
NSTL
万方数据
