三黄泻心汤治疗上消化道出血临床观察

Research on the Therapeutic Effect and Mechanism of Sanhuang Xiexin Decoction in the Treatment of Upper Gastrointestinal Bleeding

目的研究三黄泻心汤治疗上消化道出血的疗效及其作用机制。方法自鹰潭市人民医院2020年9月——2021年9月选取68例上消化道出血患者进行研究,分为对照组(34例)与试验组(34例),依据随机数字表法分组。对照组采取常规对症治疗,试验组在对照组的基础上联合三黄泻心汤治疗,2组患者均以1周为一个疗程,共治疗1个疗程。2组临床疗效(治疗后),门静脉、脾静脉血流量、中医证候积分及凝血功能(治疗前后)情况比较。结果试验组治疗后总有效率高于对照组;与治疗前比较,治疗后2组胃脘痞满、精神疲乏乏力,中医各项证候积分、门静脉、脾静脉血流量降低,且试验组低于对照组;与治疗前比较,治疗后2组患者血浆FIB、D-D水平升高,且试验组高于对照组;与治疗前比较,治疗后2组患者APTT、PT缩短,且试验组短于对照组(均P<0.05)。结论三黄泻心汤治疗上消化道出血,可有效缓解患者的临床症状,提高临床疗效,其发挥作用的机制可能与降低门静脉、脾静脉血流量,改善患者凝血功能有关。

Objective To study the efficacy and mechanism of Sanhuang Xiexin decoction in the treatment of upper gastrointestinal bleeding.Methods 68 patients with upper gastrointestinal bleeding in Yingtan people’s Hospital from September 2020 to September 2021were selected.They were divided into control group(34 cases)and experimental group(34 cases)according to the random number table method.The control group was treated with routine symptomatic treatment,and the experimental group was treated with Sanhuang Xiexin decoction on the basis of the control group.The patients in both groups were treated for one course of treatment for one week.The clinical therapeutic effects of the two groups(after treatment),portal vein and splenic vein blood flow,traditional Chinese medicine syndrome score and coagulation function(before and after treatment)situation was compared.Results The total effective rate of the experimental group after treatment was higher than that of the control group.Compared with that before treatment,the two groups had epigastric fullness,mental fatigue,traditional Chinese medicine syndrome scores,portal vein and splenic vein blood flow decreased,and the experimental group was lower than that of the control group.Compared with that before treatment,the plasma FIB and D-D levels of the two groups increased after treatment,and the experimental group was higher than that of the control group control group(all P<0.05).Conclusion Sanhuang Xiexin decoction in the treatment of upper gastrointestinal bleeding can effectively alleviate the clinical symptoms and improve the clinical curative effect.Its mechanism may be related to reducing the blood flow of portal vein and splenic vein and improving the coagulation function of patients.