大黄白及三草止血汤联合西药治疗上消化道出血(脾胃积热)随机平行对照研究

Randomized Controlled Parallel Study of Dahuang Baiji Sancao Zhixue Decoction(大黄白及三草止血汤) combined with Western Medicine in the Treatment of Upper Gastrointestinal Bleeding(Piwei Jire/脾胃积热)

[目的]观察大黄白及三草止血汤联合西药治疗上消化道出血(脾胃积热)疗效。[方法]使用随机平行对照方法,将51例门住院患者按病志号抽签方法随机分为两组,保持呼吸道通畅、抗休克、迅速补充血容量,保持水、电解质平衡,禁食、卧位。对照组25例去甲肾上腺素1~3mL+适量冷盐水,口服,3次/d;雷尼替丁,50mg/次,1次/6~8h,肌注;有条件时可行胃镜下止血。治疗组26例大黄白及三草止血汤(白及、海螵蛸、乌贼骨各20g,仙鹤草、茜草根、紫珠草各15g,大黄~生10g),水煎300mL,1剂/d,2次温服;西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、呕血消失时间、黑便消失时间、不良反应。治疗1疗程(7d),判定疗效。[结果]治疗组临床痊愈10例,显效12例,有效3例,无效1例,总有效率96.15%;对照组临床痊愈7例,显效8例,有效5例,无效5例,总有效率80.00%;呕血消失时间、黑便消失时间治疗组短于对照组(P<0.01)。[结论]大黄白及三草止血汤联合西药治疗上消化道出血(脾胃积热),疗效满意,无严重不良反应。

[Objective] To observe the curative effect of Dahuang Baiji Sancao Zhixue decoction combined with western medicine on upper gastrointestinal bleeding （Piwei Jire）. [Methods] 51 patients were randomly divided into two groups by the random parallel control method, which kept the respiratory tract unobstructed, anti shock, and supplemented the blood volume quickly, keeping the balance of water and electrolytes, fasting and lying. In the control group, 25 cases of norepinephrine 1-3mL＋cold saline, oral administration, 3 times/ d, ranitidine, 50 mg/times, 1 times/6 to 8h, and intramuscular injection, the hemostasis was feasible under the condition of gastroscope. In the treatment group, 26 cases of Dahuang Baiji Sancao Zhixue decoction （Baiji, Haipiaoqiao, Wuzeigu each 20g, Xianhecao, Qiancaogen. Zizhucao each 15g, Shengdahuang 10g）, 1 doses of/ d, 2 warm clothes, and western medicine were treated with the control group. The continuous treatment of 7d was 1 courses. Clinical symptoms, hematemesis disappearance time, black stool disappeared time and adverse reactions were observed. The 1 course of treatment （7d） was treated and the curative effect was determined. [Results] In the treatment group, 10 cases were cured, 12 cases were markedly effective, 3 cases were effective, 1 cases were invalid, the total effective rate was 96.15%, 7 cases were cured, 8 cases were markedly effective, 5 cases were effective, 5 cases were effective, 5 cases were invalid, the total effective rate was 80%, and the time of disappearance of hematemesis and the time of disappearance of black stool was shorter than that of the control group （P〈0.01）. [Conclusion] Dahuang Baiji Sancao Zhixue decoction combined with western medicine in the treatment of upper gastrointestinal bleeding （Piwei Jire） has satisfactory curative effect, no serious adverse reactions, and is worthy of promotion.