复方紫倍煎治疗急性非静脉曲张性上消化道出血的临床研究

发布时间：2019-01-30 20:59

【摘要】：目的:(1)观察复方紫倍煎治疗急性非静脉曲张性上消化道出血的临床治疗效果;(2)对复方紫倍煎治疗急性非静脉曲张性上消化道出血进行安全性评价。方法:(1)选取60例确诊为急性非静脉曲张性上消化道出血并且分级为轻中度患者,按1:1的原则区组随机化分成两组,治疗组及对照组各30例。(2)对照组患者,予对症支持处理加用兰索拉唑静脉滴注,每次30毫克,每日两次;治疗组患者,在对照组治疗上加用复方紫倍煎,一日一剂,每次90ml,分早晚两次顿服。两组均以1周为一疗程。(3)疗程结束后比较两组的临床治疗效果以及治疗组的安全性评价。结果:(1)治疗组痊愈率83.00%,显效率10.00%,有效率6.67%,对照组痊愈率60.00%,显效率23.33%,有效率16.67%,具有统计学意义(P0.05),表明复方紫倍煎结合兰索拉唑治疗急性非静脉曲张性上消化道出血的临床治疗效果较兰索拉唑组更好。(2)治疗组大便隐血转阴时间短于对照组(P0.05),治疗前两组中医症状积分、西医病情评分之间的差异均无统计学意义(P0.05),两组患者治疗前后的中医症状积分比较以及西医病情评分比较均具有显著统计学意义(P0.01),一疗程结束后两组中医症状积分、西医病情评分对比有均具有统计学意义(P0.05)。(3)两组病例治疗前后头晕、心悸、倦怠乏力、烦躁、口干、畏寒、胸闷、肠鸣、大便次数、大便量单一症状积分对照均有高度统计学意义,(P0.01),治疗组在改善头晕、乏力、口干、胸闷、大便次数等症状的临床疗效明显好于单纯兰索拉唑组(P0.05),两组治疗后心悸、烦躁、畏寒、肠鸣、大便量单一症状积分比较无统计学差异(P0.05)。(4)治疗组未发现一例出现肝肾功能异常患者,表明复方紫倍煎安全性高。结论:复方紫倍煎结合兰索拉唑用于治疗ANVUGIB,较单纯兰索拉唑组在改善临床症状、提高临床疗效等方面效果更好,同时复方紫倍煎患者使用未见明显不良反应,安全可靠,为中医药治疗ANVUGIB开拓了新思路,值得临床广泛推广。
[Abstract]:Objective: (1) to observe the clinical effect of compound Zibai decoction in treating acute non-varicose upper gastrointestinal hemorrhage, and (2) to evaluate the safety of compound Zibei decoction in treating acute non-varicose upper gastrointestinal hemorrhage. Methods: (1) 60 patients with acute non-varicose upper gastrointestinal bleeding were randomly divided into two groups according to the principle of 1:1: 30 cases in the treatment group and 30 cases in the control group. (2) the patients in the control group were divided into two groups: the control group (n = 30), the control group (n = 30) and the control group (n = 30). Treatment of symptomatic support plus intravenous drip of lansoprazole, 30 mg per time, twice a day; The patients in the treatment group were treated with compound Zibei decoction, 90 ml per day, twice in the morning and evening. (3) after the end of the treatment, the efficacy of the two groups and the safety evaluation of the treatment group were compared. Results: (1) in the treatment group, the cure rate was 83.00, the markedly effective rate was 10.00, the effective rate was 6.67 and the control group was 60.00.The markedly effective rate was 23.333.33, and the effective rate was 16.67, which was statistically significant (P0.05). The results showed that the clinical effect of compound Zibei decoction combined with lansoprazole on acute non-varicose upper gastrointestinal hemorrhage was better than that of lansoprazole group. (2) fecal occult blood conversion time in treatment group was shorter than that in control group (P0.05). Before treatment, there was no significant difference between the two groups in TCM symptom score and Western medicine disease score (P0.05). Before and after treatment, the scores of TCM symptoms and the scores of western medicine were statistically significant (P0.01). After one course of treatment, the scores of TCM symptoms in the two groups were significantly higher than those in the control group. The scores of western medicine were statistically significant (P0.05). (3) before and after treatment of two cases of dizziness, palpitations, fatigue, irritability, dry mouth, chills, chest tightness, bowel ringing, defecation times, The single symptom score of stool volume in the treatment group was significantly better than that in the lansoprazole group (P0.01) in improving dizziness, fatigue, dry mouth, chest tightness, defecation and other symptoms (P0.05). There was no significant difference in single symptom score of palpitation, irritability, chills, bowel ringing and stool volume between the two groups after treatment (P0.05). (4). Conclusion: compound Zibai decoction combined with lansoprazole is more effective than lansoprazole alone in improving the clinical symptoms and improving the clinical curative effect. At the same time, the patients with compound Zibai decoction have no obvious adverse reactions and are safe and reliable. It has opened up a new idea for the treatment of ANVUGIB with Chinese medicine, and it is worth popularizing widely in clinic.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R573.2

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