祛瘀止血散鼻胃管推注对消化性溃疡大出血患者凝血状态的影响及效果评价

To evaluate the effect of Quyuzhixuesan and effect of nasogastric tube injection on peptic ulcer bleeding in patients with coagulation

目的 ：探讨祛瘀止血散对消化性溃疡出血患者治疗效果以及凝血状态的影响。方法 ：选取2013年12月~2015年2月海口市中医院收治的消化性溃疡出血患者97例,按数字法随机分为实验组（n=49）和对照组（n=48）,对照组给予止血芳酸0.2g加5%葡萄糖250ml静滴,qd;奥美拉唑40mg加0.9%氯化钠注射液250ml静滴qd,西米替丁0.2g加5%葡萄糖500ml稀释后静脉滴注,qd,滴速为每小时2 mg/kg。实验组在此治疗基础上加用祛瘀止血散开水调匀置凉后鼻胃管推注,1袋/次,3次/天。两组均治疗10天为1个疗程,对两组患者治疗前后凝血功能生化指标进行检测,并Rockall评分后判定预后及临床效果。结果：（1）两组治疗后凝血酶原时间（prothrombin time,PT）、活化部分凝血活酶时间（activated partial thromboplatin time,APTT）、凝血酶时间（thrombin time,TT）、纤维蛋白原（Fibrinogen,FIB）,与治疗前比较均有明显降低,且实验组低于对照组（t=8.19、18.82、10.37、3.81,P〈0.05）。实验组治疗后血小板计数（blood platelet,PLT）显著高于对照组（t=6.36,P〈0.05）。（2）实验组治疗后经Rockall评分高危占24.49%,低危占22.45%,低危人数显著高于对照组,高危人数显著低于对照组（Uc=-3.8606,P〈0.01）。（3）实验组总有效率为95.92%,对照组总有效率为75.00%,实验组疗效显著优于对照组。结论：对消化性溃疡出血患者给予祛瘀止血散鼻胃管推注可以促进血小板聚集,增强患者凝血功能,从而使止血时间缩短,促进创口愈合,提高临床治疗效果。

Objective： To investigate the effect of Quyuzhixuesan on the treatment of peptic ulcer bleeding and the effect of coagulation status. Methods ： Selected december 2013 to 2015 February Haikou City Hospital of TCM from digestive ulcer bleeding 97 cases of patients, accord- ing to the digital method were randomly divided into experimental group （n = 49） and control group （n = 48）, the control group received tranexamic acid 0.2 plus 5% glucose 250ml intravenous drip, QD; omeprazole 40 mg ＋ 0.9% sodium chloride injection 250ml intravenous drip QD, sago for Ding 0.2g plus 5% glucose 500ml dilution after intravenous drip, QD, dripping speed per hour 2 mg / kg. The experi- mental group on the basis of treatment with the cool nasogastrie tube injection with quyuzhixuesan boiling water and mix thoroughly, 1 bags per time, 3 times / day. Two groups were treated for 10 days for 1 courses, two groups of patients before and after treatment of blood coagula- tion function biochemical indicators were detected, and Rockall score after the judgment of prognosis and clinical effect. Results： （ 1 ） after treatment in the two groups of prothrombin time （PT）, activated partial thromboplastin time, activated partial thromboplatin time, APTI＇）, thrombin time （and TY）, fibrin （fibrinogen FIB）, and before treatment were obviously lower than （P 〈 0.05 ）, and experimental group were lower than the control group （ t = 8.19, 18.82, 10.37, 3.81, P 〈 0.05）, the experimental group after treatment platelet count blood platelet （PLT） significantly higher than control group （ t = 6.36, P 〈 0.05 ）. （ 2 ） after treatment, the Rockall score of the experimental group was 24.49% and 22.45%, the low risk group was significantly higher than the control group, the high risk population was significantly lower than that in the control group （ Uc = -3. 8606, P 〈 0.01 ）. （3） the total effective rate of the experimental group was 95.92%, the total effective rate was 75% in the control group, the experimental group was significantly better than the control group （ Uc = 3.58, P 〈 0.01 ）. Conclusion： peptic ulcer bleeding were treated with quyuzhixuesan nasogastric tube push injection can promote platelet aggregation, enhance coagulation function of patients, thereby shortening the time to hemostasis, promote wound healing, improve the clinical treatment effect.