建中止血汤联合西药治疗上消化道出血(中阳不足)随机平行对照研究

Randomized Parallel Controlled Study of Jianzhong Zhixue Decoction(建中止血汤) combined with Western Medicine in the Treatment of Upper Gastrointestinal Bleeding(Zhongyang Buzu/中阳不足)

[目的]观察建中止血汤联合西药治疗上消化道出血(中阳不足)疗效。[方法]使用随机平行对照方法,将102例住院患者按病志号抽签方法方法随机分为两组。对照组51例奥美拉唑钠40mg+0.9%氯化钠100m L,2次/d,持续给药至出血停止3d后;经胃管注入凝血酶止血,出血过多,血红蛋白浓度<90g/L,根据需求进行输血,输注红细胞悬液、血浆,输血量与失血量相等,持续至血红蛋白浓度>90g/L。治疗组51例建中止血汤(饴糖30g,党参、黄芪、芍药各20g,当归、藕节炭各15g,枳壳、姜生、桂枝、附子、砂仁、仙鹤草、吴茱萸各10g,三七粉、甘草炙各5g),水煎300m L,早晚温服;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、止血时间、退热时间、不良反应。治疗1疗程(7d),判定疗效。随访3个月,观测再出血风险评分、再出血率。[结果]治疗组痊愈25例,好转22例,无效4例,总有效率98.04%;对照组痊愈19例,好转23例,无效9例,总有效率82.35%;临床疗效两组无显著差异(P>0.05)。止血时间、退热时间治疗组均短于对照组(P<0.01)。随访3个月,再出血风险评分、再出血率治疗组均优于对照组(P<0.05,P<0.01)。[结论]建中止血汤联合西药治疗上消化道出血(中阳不足),起效更快,有利于症状缓解,降低再出血风险,减少再出血发生。

[Objective] To observe the curative effect of Jianzhong Zhixue decoction combined with western medicine on upper gastrointestinal bleeding. [Methods] 102 cases of inpatients were randomly divided into two groups by random parallel control method. In the control group, 51 cases of omeprazole sodium 40 mg＋0.9% sodium chloride 100 m L, 2 times/d, continued to be given to the bleeding to stop 3 d, the bleeding was excessive, hemoglobin concentration was too much, hemoglobin concentration was 90 g/L, blood transfusion, transfusion of red blood cell suspension, plasma, blood transfusion and blood loss were equal, sustained to the concentration of hemoglobin〉90 g/L. In the treatment group, 51 cases of Jianzhong Zhixue decoction（Yiitang 30 g, Dangshen, Huangqi, Shaoyao each 20 g, Danggui, Tanoujie each 15 g, Zhiqiao, Shengjiang, Guizhi, Fuzi.Sharen, Xianhecao, Wuzhuyu each 10 g, Sanqi, Zhigancao each 5 g）, water decocting 300 m L, warm clothes in the morning and evening; western medicine was treated the same as the control group. The continuous treatment of 7 d was 1 courses. Observe clinical symptoms, hemostasis time, fever time and adverse reactions. The 1 course of treatment（7 d） was treated and the curative effect was determined. The risk of rebleeding and rebleeding rate were observed after 3 months follow-up. [Results] In the treatment group, 25 cases were cured, 22 cases were improved, 4 cases were invalid, the total effective rate was 98.04%, the control group cured 19 cases, 23 cases improved, 9 cases were invalid and the total effective rate was 82.35%. There was no significant difference in the clinical effect of two groups（P〉0.05）. Hemostasis time and antipyretic time in the treatment group were shorter than those in the control group（P〈0.01）. Follow up for 3 months, the risk of rebleeding and rebleeding rate in the treatment group were better than those in the control group（P〈0.05,P〈0.01）. [Conclusion] Jianzhong Zhixue decoction combined with western medicine is effective in treating upper gastrointestinal bleeding, which is beneficial to relieving symptoms, reducing the risk of rebleeding and reducing rebleeding.