上消化道出血76例临床分析

Clinical Analysis On 76 Cases of Upper Digestive Tract Haemorrhage

76例上消化道出血患者均系住院病例,以治后大便隐血试验由阳性转阴性的时间作为疗效浮价标准,76例的治后平均转阴时间为7.2天。按中医辨证,分为脾阳不振和湿热中阻两型,分别选用黄土汤和泻心汤加减治疗,其中黄土汤组43例、泻心汤组33例,其转阴时间分别为6.9天和7.5天。两者无明显差异。本组16例十二指肠球部溃疡中,用黄土汤者12例,泻心汤者4例;25例十二指肠球部溃疡兼胃窦炎者用黄土汤10例,泻心汤15例,两者差异明显(P<0.05)。提示十二指肠球部溃疡的临床表现以中虚为主,宜黄土汤;兼胃窦炎则偏于湿热,宜泻心汤。

76 cases were hospitalised patients with upper digestive tract haemorrhage.The time for OB test in stool to rum from negative to positive after treatment was taken as criteria for evaluation of the therapeutic effect.The average time for turning to negative in 76 eases was 7.2 days.Based upon pattern identification in Chinese medicine,this problem is divided into two types of deficiency of spleen Yang and accuroulation of dampheat.The treatments were given with modified Yellow Clay Decoction and Heart-Sedating Decoction.Among them,there were 43 cases treated with Yellow Clay Decoction and 33 cases treated with Heart-Sedating Decoction,and their negative-turning time was 6.9 and 7.5 days respectively.There is obvious difference betwen two groups.In the group of 16 cases with duodenal bulbar ulcer,12 cases were treated with Yellow Clay Decoction and 4 eases with Heart- Sedating Decoction.And in 25 cases with bulbar ulcer and antral gastritis,10 cases were treated with Yellow Clay Decoction,and 15 cases with Heart-Sedating Decoction.There was no remarkable difference between two groups(P<0.05).The results indicated that clinical manifestations in duodenal bulbar ulcer are deficient predominantly in the middle warmer and need to be treated with Yellow Clay Decoction,and those in antral gastritis are related to damp and heat and need to be treated with Heart-Sedating Decoction.