云南白药联合生长抑素及泮托拉唑治疗肝硬化合并上消化道出血的效果观察

Efficacy of Yunnan white medicinal powder combined with somatostatin and pantoprazole in treatment of liver cirrhosis complicated by upper gastrointestinal bleeding and its effect on inflammatory factors

目的探讨云南白药联合生长抑素及泮托拉唑治疗肝硬化合并上消化道出血的临床效果及对炎症因子的影响。方法选取2016年4月-2017年3月沈阳二四二医院收治的肝硬化合并上消化道出血患者150例,随机分为观察组和对照组各75例。对照组给予注射用生长抑素+注射用泮托拉唑钠治疗,观察组在对照组基础上加用云南白药进行治疗。观察两组患者的临床疗效、输血量、止血时间、住院时间及血红蛋白变化情况,并比较两组患者治疗前后血清中超敏C反应蛋白(hs-CRP)、IL-6水平的变化。计量资料组间比较采用t检验,计数资料组间比较采用χ~2检验,等级资料采用Ridit分析u检验。结果观察组患者的输血量、止血时间和住院时间均明显低于对照组(t值分别为6.357、7.360、4.469,P值均<0.01),治疗后血红蛋白水平明显高于对照组(t=4.042,P<0.01)。观察组患者治疗总有效率高于对照组,差异有统计学意义(96.00%vs 85.33%,u=2.564,P<0.05)。经治疗后两组患者血清hs-CRP、IL-6水平均明显降低(t值分别为14.240、6.943、35.277、17.764,P值均<0.01),治疗后观察组hsCRP、IL-6水平明显低于对照组(t值分别为7.984、18.946,P值均<0.01)。结论云南白药联合生长抑素及泮托拉唑治疗肝硬化合并上消化道出血临床疗效显著,可减少输血量,缩短止血时间和住院时间,且能降低血清hs-CRP、IL-6水平。

Objective To investigate the efficacy of Yunnan white medicinal powder combined with somatostatin and pantoprazole in the treatment of liver cirrhosis complicated by upper gastrointestinal bleeding and its effect on inflammatory factors.Methods A total of 150 patients with liver cirrhosis complicated by upper gastrointestinal bleeding who were admitted to Shenyang 242 Hospital from April 2016 to March 2017 were enrolled and randomly divided into observation group and control group,with 75 patients in each group.The patients in the control group were given somatostatin for injection+pantoprazole sodium for injection,and those in the observation group were given Yunnan white medicinal powder in addition to the treatment for the control group.The two groups were observed and compared in terms of clinical outcome,blood transfusion volume,time to hemostasis,length of hospital stay,and change in hemoglobin,as well as the changes in the serum levels of high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)after treatment.The t-test was used for comparison of continuous data between groups,the chi-square test was used for comparison of categorical data between groups,and the Ridit analysis and the u test were used for ranked data of clinical outcome.Results Compared with the control group,the observation group had a significantly lower blood transfusion volume and significantly shorter time to hemostasis and length of hospital stay(t=6.357,7.360,and 4.469,all P<0.01),as well as a significantly higher level of hemoglobin after treatment(t=4.042,P<0.01).The observation group had a significantly higher overall response rate than the control group(96.00%vs 85.33%,u=2.564,P<0.05).Both groups had significant reductions in the serum levels of hs-CRP and IL-6 after treatment(t=14.240,6.943,35.277,and 17.764,all P<0.01),and the observation group had a significantly higher level of hs-CRP and IL-6 than the control group after treatment(t=7.984 and 18.946,both P<0.01).Conclusion Yunnan white medicinal powder combined with somatostatin and pantoprazole has a marked clinical effect in the treatment of liver cirrhosis complicated by upper gastrointestinal bleeding and can reduce blood transfusion volume,shorten the time to hemostasis and length of hospital stay,and reduce the serum levels of hs-CRP and IL-6.