摘要
目的观察清热降逆止血方联合奥美拉唑钠治疗急性非静脉曲张上消化道出血(acute non-variceal upper gastrointestinal bleeding, ANVUGIB)的疗效。方法将符合入选标准的64例ANVUGIB患者采用随机数字表法分为2组,每组32例。对照组在常规治疗基础上静脉滴注奥美拉唑钠,观察组在对照组基础上加服清热降逆止血方。2组均连续治疗7 d。观察并记录患者止血时间、输血量、住院时间,计算72 h止血率、再出血率;采用全自动化学发光免疫分析仪检测血浆皮质醇、MDA及血管升压素;采用血糖仪检测患者血糖;采用ELISA法检测超敏C反应蛋白(hypersensitive C-reactive protein, hs-CRP)、TNF-α、IL-1β,评价临床疗效。结果观察组总有效率为90.6%(29/32)、对照组为71.9%(23/32),2组比较差异有统计学意义(χ^2=4.730,P=0.029)。治疗后,观察组止血时间[(18.9±3.0)h比(29.1±4.1)h,t=7.354]、输血量[(559.3±67.2)ml比(612.7±75.8)ml,t=11.032]、再出血率(3.1%比21.9%,χ^2=5.143)及住院时间[(5.4±0.7)d比(9.3±1.2)d,t=5.871]均低于对照组(P<0.05),72 h止血率(96.9%比81.3%,χ^2=4.010)高于对照组(P<0.05)。治疗后,观察组血浆皮质醇、MDA、血糖及血管升压素水平均低于对照组(t值分别为8.106、4.976、4.842、5.093,P<0.01);血浆hs-CRP、TNF-α、IL-1β水平低于对照组(t值分别为5.506、4.983、7.962,P<0.01)。结论清热降逆止血方联合奥美拉唑钠可有效抑制ANVUGIB患者炎性细胞因子表达,降低出血所致的氧化应激损伤,提高止血效率。
Objective To observe the clinical effect of Qingre-Jiangni-Zhixue decoction combined with omeprazole sodium on acute non-variceal upper gastrointestinal bleeding. Methods A total of 64 patients with acute non-variceal upper gastrointestinal bleeding were divided into the observation group and control group according to random number table method, with 32 cases in each group. The control group was given the routine clinical treatment combined with omeprazole sodium, and the observation group was given Qingre-Jiangni-Zhixue decoction on the basis of the control group. After 7 days of continuous treatment, the basic clinical indexes (hemostasis time, blood transfusion volume, hospitalization time, 72 hours hemostasis rate, rebleeding rate), oxidative stress indexes (cortisol, malondialdehyde, antidiuretic hormone, blood glucose) and serum inflammatory factors (hs-CRP, TNF-α, IL-1β) were observed before and after treatment, and the clinical efficacy were evaluated. Results The total effective rate of the observation group was 90.6%(29/32), which was significantly higher than that of the control group 71.9%(23/32), with statistically significant (χ^2=4.730, P=0.029). After treatment, the hemostasis time (18.86 ± 2.97 h vs. 29.12 ± 4.07 h, t=7.354), blood transfusion volume (559.32 ± 67.17 ml vs. 612.73 ± 75.81 ml, t=11.032), hospitalization time (5.43 ± 0.67 d vs. 9.26 ± 1.15 d, t=5.871) of the observation group were significantly lower than those of the control group (P<0.05). The 72 h hemostasis rate of the observation group was 3.1%, which was significantly lower than that of the control group 21.9%, with statistically significant (χ^2=5.143, P<0.05). The rebleeding rate of the observation group was 96.9%, which was significantly higher than that of the control group 81.3%(χ^2=4.010, P=0.045). After treatment, the cortisol level, the malondialdehyde level, blood glucose, antidiuretic hormone of the observation group were lower than those of the control group (t were 8.106, 4.976, 4.842, 5.093, all Ps<0.0
作者
肖勇
方玉明
夏正新
Xiao Yong;Fang Yuming;Xia Zhengxin(The Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201999,China)
出处
《国际中医中药杂志》
2019年第4期347-351,共5页
International Journal of Traditional Chinese Medicine
关键词
急性非静脉曲张上消化道出血
止血剂(中药)
清热降逆止血方
奥美拉唑钠
氧化性应激
危险分层
预后评估
Acute non-variceal upper gastrointestinal bleeding
Hemostatic formula (TCD)
Qingre-Jiangni-Zhixue decoction
Omeprazole sodium
Oxidative stress
Risk stratifi cation
Prognosis prediction
