滋阴止血方加减治疗肺结核急性大咯血临床研究

Nourishing Yin and Stoping Bleeding Decoction in Treatment of Acute Massive Hemoptysis with Tuberculosis

目的:观察滋阴止血方加减治疗肺结核急性大咯血的临床疗效。方法:196例肺结核急性大咯血患者随机分为观察组98例和对照组98例。对照组给以支气管动脉栓塞术,观察组在对照组基础上给以滋阴止血方加减。术后随访2 a,观察两组患者的治疗效果、止血时间及不良反应等。结果:观察组治愈56例,显效27例,有效率为92.86%;对照组治愈36例,显效33例,有效率为80.61%。观察组止血时间(2.1±1.0)d,即时止血率87.76%,2年内复发率7.14%;对照组止血时间(3.8±1.9)d,即时止血率59.18%,2年内复发率29.59%;两组比较,差异均有统计学意义(P<0.05)。两组患者均出现不同程度的腹泻腹痛、发热、胸胁胸痛等不良反应,经对症治疗后均缓解,且观察组的不良反应发生率显著低于对照组(P<0.05)。结论:滋阴止血方加减治疗肺结核急性大咯血疗效较好,并且不良反应较少。

Objective： To explore the efficacy of nourishing Yin and stopping bleeding decoction in treatment of acute massive hemoptysis with tuberculosis. Methods： 196 cases of hemoptysis patients were randomly divided into experiment group（ 98 cases） and control group（ 98 cases）. Bronchial artery embolization was applied to the control group,while the experiment group was treated with nourishing Yin and stopping bleeding decoction besides that. Patients were followed up for 2 years,and the treatment effectiveness of the two groups was observed in bleeding time control and adverse reactions. Results： 56 cases were cured and 27 cases got effectively improved in experiment group with the total effective rate being 92. 86%; 36 cases were cured and 33 cases got effectively improved in control group with total effective rate being 80. 61%. the average time of hemostasis was（ 2. 1 ± 1. 0） d,the immediate hemostasis was 87. 76% and the relapse rate within 2 years was7. 14% of the experimental group; the average time of hemostasis was（ 3. 8 ±1. 9） d,the immediate hemostasis was 59. 18%,and the relapse rate within 2 years was 29. 59% of the control group. The differences of the two groups were statistically significant. Besides,the adverse reactions of the two groups such as diarrhea,abdominal pain,fever,and chest pain were relieved after treatment,and the incidence of adverse reactions in the experiment group was significantly lower than that of the control group. Conclusion： nourishing Yin and stopping bleeding decoction has batter clinical efficacy with less adverse reaction,which can be used in clinical treatment of acute massive hemoptysis with tuberculosis.