中医辨证治疗联合生长抑素对急性上消化道出血患者外周血血红蛋白、高敏c反应蛋白、白介素-6水平及再次出血风险的影响

Effect of Traditional Chinese Medicine Dialectical Therapy Combined with Somatostatin on Levels of Peripheral Blood Hemoglobin, High-sensitivity C-reactive Protein and Interleukin-6 and Risk of Rebleeding for Patients with Acute Upper Gastrointestinal Bleeding

目的:探究中医辨证疗法联合生长抑素对急性上消化道出血(ANVUGIB)患者的治疗效果。方法:选取2019年1月~2020年4月到我院就诊的ANVUGIB患者136例,采用随机数字表法将其分为研究组和对照组各68例。对照组采用生长抑素及急性上消化道出血常规治疗;研究组在对照组的基础上采用中医辨证疗法联合生长抑素治疗。比较两组治疗前及治疗5d时的外周血相关因子[血红蛋白(Hb)、高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)]水平、凝血功能指标[凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)]变化;比较两组患者的恢复情况(大便隐血转阴时间、血压稳定时间、住院时间)及再出血状况(再出血率、再出血持续时间、再出血输血量);比较两组治疗5d时的临床疗效及预后评估(Rockall危险性积分)。结果:治疗5d时,两组外周血Hb含量较治疗前明显升高,且研究组显著高于对照组(P<0.05);两组外周血Hs-CRP及IL-6含量于治疗5d时明显降低,且研究组显著低于对照组(P均<0.05);治疗5d时两组PT、APTT指数及FIB含量较治疗前均明显改善,且研究组显著优于对照组(P均<0.05);治疗期间,研究组的大便隐血转阴时间、住院时间、再出血率及再出血持续时间较对照组显著改善(P均<0.05),但两组间血压稳定时间及再出血输血量无统计学差异(P均>0.05);研究组治疗5d时的临床疗效及Rockall预后评估状况显著优于对照组(P均<0.05)。结论:中医辨证疗法联合生长抑素对ANVUGIB患者有良好的治疗效果。

Objective:To explore the therapeutic effect of TCM dialectical therapy combined with somatostatin for patients with acute upper gastrointestinal bleeding(ANVUGIB).Methods:Totally 136 patients with ANVUGIB who came to our hospital were selected between January 2019 and April 2020,and they were divided into a study group and a controlled group according to the random number table method,with 68 cases in each group.The controlled group was treated with somatostatin and conventional therapy for acute upper gastrointestinal bleeding,and the study group was given TCM dialectical therapy combined with somatostatin on the basis of the controlled group.The levels of peripheral blood-related factors[hemoglobin(Hb),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)]and coagulation function indexes[prothrombin time(PT),activated partial thrombin time(APTT),fibrinogen(FIB)]were compared between the two groups before treatment and at 5 d of treatment.The recovery status(negative conversion time of fecal occult blood,blood pressure stability time,hospital stay)and rebleeding status(rebleeding rate,rebleeding duration,rebleeding blood transfusion)were compared between the two groups.The clinical efficacy and prognosis assessment(Rockall risk score)were compared between the two groups at 5 d of treatment.Results:At 5 d of treatment,the level of peripheral blood Hb of the two groups was significantly higher than that before treatment,and the level of the study group was significantly higher than that of the controlled group(P<0.05).The levels of peripheral blood Hs-CRP and IL-6 in the two groups were significantly decreased at 5 d of treatment,and the levels of the study group were significantly lower than those of the controlled group(all P<0.05).The PT,APTT index and FIB level of the two groups at 5 d of treatment were significantly improved compared with those before treatment,and the three indexes of the study group were significantly better than those of the controlled group(all P<0.05)During treatment,the negative conversion time of fecal occult blood,hospital stay,rebleeding rate and rebleeding duration in the study group were significantly improved compared with those in the controlled group(all P<0.05),but there were no statistical differences in the blood pressure stability time and rebleeding blood transfusion between the two groups(all P>0.05).The clinical efficacy and Rockall prognosis assessment status of the study group at 5 d of treatment were significantly better than those of the controlled group(all P<0.05).Conclusion:TCM dialectical therapy combined with somatostatin has a good therapeutic effect for patients with ANVUGIB.