复方大红袍止血胶囊联合维生素K1治疗胆道术后出血的临床研究

Clinical study of Compound Dahongpao Zhixue Capsules combined with vitamin K in treatment of postoperative biliary hemorrhage

目的探讨复方大红袍止血胶囊联合维生素K1治疗胆道术后出血的治疗效果。方法选择2013年6月—2019年8月来重庆市石柱县中医院治疗的80例胆道术后出血患者作为研究对象,按照治疗方法将患者分为对照组(n=40)和观察组(n=40)。对照组患者给予维生素K1注射液治疗,10 mg/次,2次/d。观察组患者在对照组治疗的基础上外加复方大红袍止血胶囊,4粒/次,3次/d。比较两组患者的24 h内止血率、输血量、止血时间及住院时间。分析两组患者治疗前后的血清标志物以及肝功能变化。随访3个月,观察两组患者预后再出血发生率。结果治疗后,观察组24 h内止血率高于对照组,输血量、止血时间、住院时间均显著低于对照组(P<0.05)。治疗后,两组患者的血清甘胆酸(CG)、人层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)水平显著降低(P<0.05),且观察组血清CG、LN和PCⅢ水平降低更明显(P<0.05)。治疗后,两组Child-Pugh改良评分均显著降低(P<0.05);且观察组明显低于对照组(P<0.05)。术后随访3个月,观察组患者的再出血发生率明显低于对照组(P<0.05)。结论复方大红袍止血胶囊联合维生素K1可以较好的控制患者胆道术后出血,改善肝功能,降低再次出血的发生率,效果较好,具有一定的临床应用价值。

Objective To investigate the therapeutic effect of Compound Dahongpao Zhixue Capsules combined with vitamin K1 in treatment of postoperative biliary hemorrhage.Methods Eighty patients with postoperative biliary tract hemorrhage treated in Shizhu County Hospital of Traditional Chinese Medicine from June 2013 to August 2019 were selected as the research subjects,and the patients were divided into control group(n=40)and observation group(n=40)according to the treatment methods.Patients in the control group were given Vitamin K1 Injection,10 mg/time,twice daily.Patients in the observation group was additively treated with Compound Dahongpao Zhixue Capsules,4 capsules/time,three times daily.The hemostasis rate within 24 h,blood transfusion volume,hemostasis time and hospitalization time of two groups were compared.Serum markers and liver function changes before and after treatment were analyzed in two groups.Follow-up for 3 months was conducted to observe the difference in the rate of prognostic rebleeding between the two groups.Results After treatment,the hemostasis rate in observation group within 24 h was higher than that in control group,and the amount of blood transfusion,hemostasis time and hospitalization time were significantly lower than those in control group(P<0.05).After treatment,the serum levels of CG,LN,and PCⅢwere significantly reduced in two groups(P<0.05),and the observation group reduce the level of serum CG,LN,and PCⅢwere more obvious(P<0.05).After treatment,Child-Pugh improved scores in two groups were significantly decreased(P<0.05),and the observation group was significantly lower than the control group(P<0.05).The incidence of rebleeding in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Compound Dahongpao Zhixue Capsules combined with vitamin K1 can better control postoperative biliary bleeding,improve liver function,reduce the incidence of rebleeding,the effect is good,has a certain value of clinical application.