清热止血方治疗肝硬变上消化道出血胃热炽盛证临床研究

Clinical Study of Qingre Zhixue Prescription in the Treatment of Liver Cirrhosis with Upper Gastrointestinal Hemorrhage of Exuberance Stomach Heat Syndrome

目的:观察清热止血方治疗肝硬变上消化道出血胃热炽盛证的临床疗效。方法:68例肝硬变上消化道出血胃热炽盛证患者按照随机数字表法分为观察组与对照组各34例。对照组给予生长抑素等综合治疗,观察组在对照组治疗基础上给予清热止血方。连续治疗5 d为1个疗程。治疗后比较两组患者临床疗效、出血停止时间、输血量、血流动力学指标的变化(门静脉血流、门静脉内径)以及凝血功能的改善,比较两组患者治疗前后红细胞计数(red blood cell,RBC)和血红蛋白(hemoglobin,Hb)水平,观察治疗48 h再次出血发生率及平均住院时间。结果:治疗后,观察组有效率优于对照组(P<0.05),止血时间、输血量均少于对照组(P<0.05),血流动力学改变优于对照组(P<0.05),凝血功能改善优于对照组(P<0.05),48 h内再次出血发生率低于对照组(P<0.05),住院时间少于对照组(P<0.05)。治疗后,两组患者RBC和Hb水平均显著高于治疗前(P均<0.05),且观察组治疗后RBC和Hb水平高于对照组(P>0.05)。结论:清热止血方治疗肝硬变上消化道出血疗效显著,能明显缩短患者出血时间,减少输血量,降低血流动力学,改善凝血功能,降低再次出血发生率,升高血红蛋白及红细胞,纠正贫血,缩短住院时间。

Objective:To observe the clinical efficacy of Qingre Zhixue prescription in the treatment of liver cirrhosis with upper gastrointestinal hemorrhage of exuberance stomach heat syndrome.Methods:68 patients with liver cirrhosis with upper gastrointestinal hemorrhage of exuberance stomach heat syndrome were divided into observation group and control group according to random number table method,34 cases in each group.The control group was treated with somatostatin and other comprehensive treatment,while the observation group was treated with Qingre Zhixue prescription on the basis of the control group.Continuous treatment for 5 days is a course of treatment.After treatment,the clinical efficacy,hemorrhage stopping time,blood transfusion volume,hemodynamic changes(portal vein blood flow,portal vein diameter) and improvement of coagulation function were compared between the two groups.The levels of red blood cell(RBC) and hemoglobin(Hb) were compared before and after treatment.The incidence of re-bleeding and average hospitalization time after 48 hours of treatment were observed.Results:After treatment,the effective rate of the observation group was better than that of the control group(P<0.05).Hemostasis time and blood transfusion volume were less than that of the control group(P<0.05).Hemodynamic changes were better than that of the control group(P<0.05).Coagulation function was better than that of the control group(P<0.05).The incidence of re-bleeding within 48 hours was lower than that of the control group(P<0.05),and hospitalization time was shorter than that of the control group.After treatment,RBC and Hb in the two groups were significantly higher than those before treatment(P<0.05),and RBC and Hb in the observation group were higher than those in the control group(P>0.05).Conclusion:Qingre Zhixue prescription has remarkable curative effect on liver cirrhosis with upper gastrointestinal hemorrhage.It can shorten bleeding time,reduce blood transfusion,reduce hemodynamics,improve coagulation function,reduce the incidence of re-bleeding,increase hemoglobin and erythrocyte,correct anemia and shorten hospitalization time.