泻心汤合十灰散联合西药治疗上消化道出血临床疗效观察

Clinical Observation on Treatment of Upper Gastrointestinal Bleeding with Xiexin Decoction and Decoction Combined with Western Medicine

目的:探讨泻心汤合十灰散联合泮托拉唑治疗上消化道出血患者临床疗效。方法:截选86例诊断为上消化道出血患者按照随机数字表法分为对照组(泮托拉唑40mg+0.9%氯化钠溶液250ml静脉滴注)与治疗组(于对照组治疗基础上采用泻心汤合十灰散治疗),各43例。评价两组临床疗效,并记录有效止血时间、24h再出血率,评价两组患者治疗前后临床各项中医证候积分变化,统计两组治疗期间不良反应。结果:治疗后治疗组患者治疗总有效率90.7%,明显高于对照组69.8%,P<0.05;治疗组有效止血时间(18.9±5.1)h明显短于对照组(30.7±6.9)h,P<0.05;治疗组24h再出血率4.7%明显低于对照组18.6%,P<0.05。两组患者各项中医证候积分较治疗前明显下降,治疗组治疗后各项中医证候积分明显低于对照组,P<0.05;治疗组不良反应率4.7%,明显少于对照组20.9%,P<0.05。结论采用泮托拉唑联合泻心汤合十灰散治疗上消化道出血疗效显著且安全。

Abstract： objective To explore the clinical effect of Xiexin Decoction and Decoction combined with pantoprazole in treatment of upper gastrointestinal bleeding. Methods 86patients diagnosed as upper gastrointestinal bleeding were randomly divided into control group （pantoprazole 40rag ＋ 0. 9% sodium chloride solution 250ml intravenous infusion） and the treatment group （based on the control group） Using Xie Xin Tang Decoction treatment）, the 43cases. The curative effect of the two groups was evalua- ted and the effective hemostatic time and 24-hour rebleeding rate were recorded. The change of TCM syndrome scores before and after treatment in the two groups was evaluated and the adverse reactions during the treatment were analyzed. Results After treat- ment, the total effective rate of treatment group was 90. 7%, which was significantly higher than that of the control group （69. 8%, P〈0. 05 ） ; the effective hemostatic time was （18.9±5.1） h in the treatment group （30. 7±6. 9）. The rebleeding rate was 4. 7% in the treatment group and 18. 6% in the control group （P〈0. 05）. The TCM syndrome score of the two groups was significantly lower than that of the control group before treatment and the scores of TCM syndrome after treatment were significantlylower than those of the control group （ P〈0. 05 ）. The adverse reaction rate of the treatment group was 4. 7%, significantly lower than the control group 20. 9%, P〈0. 05. Conclusion Pantoprazole combined with Xie Xin Tan~ Decoction in the treatment of up- per gastrointestinal bleeding was significant and safe.