冰冻紫地合剂胃内灌注救治急性上消化道出血的临床研究  

Therapeutic effect evaluation on the treatment of acute upper gastrointestinal bleeding with freezing Zidi mixture lavage

作　　者：郭佳莹[1] 欧秀娟[1] 王俏芝[1] 

机构地区：[1]广州中医药大学第一附属医院急诊科普内病区,510405

出　　处：《国际中医中药杂志》2014年第7期596-599,共4页International Journal of Traditional Chinese Medicine

摘　　要：目的：观察冰冻紫地合剂灌胃救治急性上消化道出血的临床疗效。方法收集2011年1月至2013年8月广州中医药大学第一附属医院急诊科普内病区急性上消化道出血（upper gastrointestinal bleeding，UGIB）患者183例，按随机数字表法将患者随机分为两组，治疗组92例采用冰冻紫地合剂胃内灌注治疗；对照组91例采用冰盐水配合去甲肾上腺素胃内灌注治疗。分别于治疗前后观察两组患者的血压、血红蛋白、血尿素氮、脉搏及黑便等主要症状体征的变化，并评价治疗前后焦虑、抑郁、恐惧等不良情绪。结果①临床疗效比较：治疗后治疗组总有效率为96.7%（89/92）、对照组为85.7%（78/91），两组总有效率比较，差异有统计学意义（χ^2＝2.943，P＜0.05）。②症状消失时间比较：治疗后治疗组呕血、黑便及隐血试验阴转时间均明显短于对照组（t值分别为6.628、14.052、21.706，P＜0.05或0.01）。③症状体征比较：治疗后治疗组收缩压、心率、血红蛋白、血尿素氮[（114.3±12.1）mmHg、（78.6±11.4）次/min、（98.1±10.5）g/L、（5.9±1.1）mmol/L]均较对照组治疗后[（106.3±11.2）mmHg、（88.7±12.1）次/min、（88.2±11.7）g/L、（6.9±1.4）mmol/L]明显改善（P＜0.05）。治疗后两组体温均升至正常，但组内组间比较差异均无统计学意义（P＞0.05）。④焦虑、抑郁及正负性情绪变化比较：治疗后治疗组焦虑、抑郁及正负性情绪[分别为（42.5±9.4）分、（41.6±9.7）分、（26.3±5.4）分]均较对照组治疗后[分别为（51.2±10.1）分、（50.4±11.5）分、（30.4±6.9）分]明显改善（P＜0.05）。结论冰冻紫地合剂胃内灌注治疗 UGIB，可升高患者收缩压、降低心率、升高血红蛋白，降低血尿素氮水平，缓解机体应激反应，减轻相关症状。Objective To observe the clinical effects of treating acute upper gastrointestinal bleeding（AUGIB） with freezing Zidi mixture lavage. Method 183 UGIB patients from the First Affiliated Hospital to Guanzhou University of TCM in August 2013 were randomly recruited into a control group with 91cases and a treatment group with 92 cases. The treatment group was treated with intragastric administration of freezing Zidi mixture, while the control group was treated with intragastric administration of cryohydrate and norepinephrine. The changes of clinical effects, blood pressure, hemoglobin, blood urea nitrogen, pulse and dark stool were observed and the bad emotions as anxiety, depression and fear were evaluated. Results ① On therapeutic effect, the total effective rate was 96.7% and 85.7% in the treatment group and the control group respectively, with statistical difference（χ^2=2.943,P〈0.05）. ② On the time of symptom disappearance：the disappearing time of vomiting, dark stools and occult blood test in the treatment group was obviously shorter than the control group after the treatment（t=6.628、14.052、21.706,P〈0.05 or 0.01）. ③ On body symptom changes： after the treatment, the systolic pressure, heart rate, hemoglobin, and blood urea nitrogen [（114.3±12.1）mmHg,（78.6±11.4）/min,（98.1±10.5）g/L,（5.9±1.1）mmol/L] in the treatment group were all obviously improved than those [（106.3±11.2）mmHg, （88.7±12.1）/min,（88.2±11.7）g/L,（6.9±1.4）mmol/L] in the control group;body temperature returned to normal in both groups, and there was no statistical difference score was either in or between groups（P〉0.05）. ④ On changes of anxiety, depression and fear：the treatment group [the（42.5±9.4）, （41.6±9.7）, （26.3±5.4）for each]was obviously improved after the treatment than the control group[the score was（51.2±10.1）,（50.4±11.5）,（30.4±6.9）for each],P〈0.05. Conclusion Freezing Zidi mixture lavage can obviously elevate systolic pressure, dec

关 键 词：冰冻紫地合剂 急性上消化道出血 胃内灌注 

分 类 号：R259[医药卫生—中西医结合]