中西医结合治疗上消化道出血50例疗效观察

Observations on curative effects of integrated traditional Chinese medicine and western medicine on 50 cases with upper digestive tract hemorrhage

目的：观察中西医结合治疗上消化道出血的疗效。方法：中西医结合组５０例辨证分型，分为脾虚不摄型、脾虚寒热相挟型、肝胃积热型、胃阴损伤型和气随血脱型。采用主方四君子汤合半夏泻心汤化裁，加化瘀止血药，另予血竭粉，结合雷尼替丁注射液静滴；西药对照组用雷尼替丁注射液、止血芳酸和止血敏静滴及去甲肾上腺素稀释液口服；２组均给予必要的对症和支持治疗。结果：中西医结合组的止血显效率和总有效率均优于西药组，２组止血显效率比较有显著性差异（χ２＝８．２００３，Ｐ＜０．００５），而总有效率比较无显著性差异（χ２＝３．２０２４，Ｐ＞０．０５），止血时间中西医结合组为（３．３８±１．６８）日，西药组为（５．０５±２．４５）日，２组比较有显著性差异（ｔ′＝３．６１５２，Ｐ＜０．０１）。结论：用中医中药调正整体、化瘀止血治疗上消化道出血具有优势；中西医结合治疗可以相辅相成。

Objective:To observe the curative effects of integrated traditional Chinese medicine(TCM) and western medicine (WM) on upper digestive tract hemorrhage (UDTH).Methods:According to the syndrome differ classification of TCM 50 cases of integrated TCM WM group were classified into Pixu Bushe(脾虚不摄)type,Pixu Hanre Xiangxie(脾虚寒热 相挟)type,Ganwei Jire(肝胃积热) type,Weiyin Sunshang(胃阴损伤) type and Qisui Xuetuo(气 随血脱)type.The main decoction,modified Sijunzi Decoction(四君子汤) combined Banxia Xiexin Decoction(半夏泻心汤)were used simultaneously,the herbs of hemostasis and removing blood stasis were added otherwise powder of resina draconis was taken orally in combination with ranitidine injection infused intravenously.In control group of WM the ranitidine injection,acid aminomethyl benzoicum,and dicynonum were infused intravenously and the solution of diluted noradrenaline was taken orally,meantime the necessary symptomatic and supportive therapies were applied.Results:All the markedly effective rate and total effective rate for hemostasis in integrated TCM WM group were superior to those in WM group.In comparison between two groups the markedly effective rate of hemostasis was significantly different (χ 2=8 200 3, P <0 005) but there was no significant difference in total effective rate (χ 2=3 202 4, P >0 05). The times of hemostasis were (3 38±1 68) days in integrated TCM WM group and (5 05±2 45) days in WM group respectively.The difference was significant ( t ′=3 615 2, P <0 01).Conclusions:The treatment with TCM to regulate the whole body and with herbs of removing blood stasis and hemostasis for UDTH possesses superiority.The treatment with integrated TCM WM has the actions of supplement each other and learning from others′ strong points to offset one′s weaknesses.