温胃暖脾汤联合西药治疗非急性上消化道出血(脾胃虚寒)随机平行对照研究

Wenwei Nuanpi Decoction(温胃暖脾汤) combined with Western Medicine for Treatment of Non Acute Upper Gastrointestinal Bleeding(Piwei Xuhan/脾胃虚寒) Random Parallel Control Study

[目的]观察温胃暖脾汤联合西药治疗上消化道出血(脾胃虚寒)疗效。[方法]使用随机平行对照方法,将76例住院患者按病志号抽签简单随机分为两组。对照组36例垂体后叶素30U+生理盐水250mL,0.1~0.2U/min,静滴,连续12h,逐渐减少;止血后,奥美拉唑40mg+100mL生理盐水,8h 1次。治疗组34例温胃暖脾汤(地黄~熟、白芍、藕节~炭各15g,黄芪~炙、白术~炒各12g,茯苓10g,姜^(炮炭)、甘草~炙各6g),血虚加当归15g;气虚加党参15g;脘腹胀痛加木香、枳壳各10g;呕吐吞酸加海螵鞘15g;呕吐反胃加竹茹20g、半夏~法8g、姜生3g;西药治疗同对照组。连续治疗1周为1疗程。观测临床症状、呕血停止时间、便血停止时间、止血时间、不良反应。治疗1疗程(1周),判定疗效。[结果]治疗组痊愈22例,有效14例,无效2例,总有效率94.747%;对照组痊愈15例,显效12例,无效11例,总有效率71.05%;治疗组疗效优于对照组(P<0.05)。呕血停止时间、便血停止时间、止血时间治疗组明显短于对照组(P<0.01)。不良反应两组无显著差异(P>0.05)。复发率两组无显著差异(P>0.05)。[结论]温胃暖脾汤联合西药治疗上消化道出血(脾胃虚寒),疗效满意,无严重不良反应,值得推广。

[Objective] To observe the therapeutic effect of warming stomach warming spleen decoction combined with western medicine on upper gastrointestinal bleeding （spleen stomach deficiency cold）. [Methods] Using random parallel control method, 76 inpatients were randomly divided into two groups according to the drawing number of disease records. In the control group, 36 cases of pitnitrin 30U＋physiological saline 250mL, 0.1-0.2 U/min, intravenous drip, continuous 12h, gradually decreasing; after hemostasis, omeprazole 40 mg/times, 100mL physiological saline, and 1 times/8h. In the treatment group, 34 eases of Wenwei Nuanpi decoction （Shudihuang, Baishao, Oujietan each 15g, Zhihuangqi, Chaobaizhu each 12g, Fuling 10g, Paojiangtan, Zhigancao each 6g）, blood deficiency plus Danggui 15g, Qi deficiency plus Dangshen 15g, abdominal distention and pain plus Muxiang, Zhiqiao each 10g, vomiting and acid and 15g of Halpaioqiao, vomiting and nausea with Zhuru 20g, Fabanxia 8g, Shengjiang 3g; western medicine treatment with the control group. Continuous treatment for 1 -weeks was the 1 course of treatment. Observe clinical symptoms, stop bleeding time, stop bleeding time, hemostasis time and adverse reactions. The 1 course of treatment （1 weeks） was treated and the curative effect was determined. [Results] In the treatment group, 22 cases were cured, 14 eases were effective, 2 cases were invalid and the total effective rate was 94.747%. The control group cured 15 cases, 12 cases were markedly effective, 11 cases were invalid and the total effective rate was 71.05%. The curative effect of the treatment group was better than that of the control group （P〈0.05）. The duration of hematemesis, hemostasis time and hemostasis time in the treatment group were significantly shorter than those in the control group （P〈0.01）. There was no significant difference in the adverse reaction between the two groups （P〉0.05）. There was no significant difference in the recurrence rate between the two groups （e〉0.05）. [Conclusion] Wenwei Nuanpi decoction combined with western medicine for treatment of upper gastrointestinal bleeding （Piwei Xuhan） has satisfactory curative effect, no serious adverse reactions,and is worthy of promotion.