大黄保留灌肠联合西药预防急性重症脑血管并发应急性溃疡随机平行对照研究  

Rhubarb Retention Enema combined with Western Medicine to Prevent Acute Severe Cerebral Vascular Ulcer Concurrent Emergency Randomized Controlled Study

作　　者：何剑华 宋子贤 黄滨 

机构地区：[1]广西南宁市第九人民医院内三科,南宁530409

出　　处：《实用中医内科杂志》2015年第6期112-114,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察大黄保留灌肠联合西药预防急性重症脑血管并发应急性溃疡疗效。[方法]使用随机平行对照方法，将60例住院患者按掷骰子法简单随机分为两组。对照组30例心电监护、加强气道管理、保护脑细胞、维持水电解质平衡、营养支持及脱水降颅压、控制血压、血糖等对症处理及支持；质子泵抑制剂等常规护胃。40mg奥美拉唑＋100mL 0.9%氯化钠，1次/d，静滴，已发生溃疡2次/d。治疗组30例大黄保留灌肠，生大黄60g，水煎取汁150-200mL，晾至37℃，左侧卧位，抬高臀部灌肠，插肛管40-50cm，保留灌肠40min，隔日灌肠；西药治疗同对照组。连续治疗7d为1疗程。观测临床症状、胃液指标（胃液量、胃液PH）、血浆内皮素、不良反应。治疗1疗程，判定疗效。[结果]治疗组显效23例，有效5例，无效2例，总有效率93.33%。对照组显效14例，有效8例，无效8例，总有效率73.33%。治疗组疗效优于对照组（P＜0.05）。胃液指标两组均有改善（P＜0-01），治疗组改善优于对照组（P＜0-01）。血浆内皮素两组均有改善（P＜0-01），治疗组改善优于对照组（P＜0-01）。[结论]大黄保留灌肠联合西药预防急性重症脑血管并发应急性溃疡疗效满意，无严重不良反应，值得推广。[Objective] To observe the rhubarb retention enema combined with western medicine to prevent acute severe cerebral vascular ulcer concurrent emergency. [Methods] Randomized, parallel controlled method, 60 cases of hospitalized patients were randomly divided into two groups craps method is simple. 30 patients ECG, strengthen the airway management, protect brain cells, maintain water and electrolyte balance, nutritional support and dehydration reduce intracranial pressure, control blood pressure, blood sugar and other symptomatic treatment and support; proton pump inhibitors and other conventional Huwei. 40 mg omeprazole ＋ 100 m L 0.9% sodium chloride, 1 times/d, intravenous infusion, had ulcers 2 times/d occur. Treatment group of 30 patients rhubarb retention enema, Shengdahuang 60 g, decoction juice 150-200m L, dry to 37℃, the left lateral position, raise the buttocks enema, anal plug 40-50cm, retention enema 40 min, enema every other day; medicine Treatment with the control group. 7d for a course of continuous treatment. Observation of clinical symptoms, gastric indicators（gastric juice, gastric PH）, plasma endothelin, adverse reactions. One course of treatment, to determine efficacy. [Results]The treatment group 23 cases, effective in 5 cases, 2 cases, the total efficiency of 93.33%. The control group 14 cases markedly effective in 8 cases, 8 cases, the total efficiency 73.33%. Treatment group than the control group（P〈0.05）. Gastric indicators improved in both groups（P〈0-01）, the treatment group than the control group improved（P〈0-01）. Endothelin improved in both groups（P〈0-01）, the treatment group than the control group improved（P〈0-01）. [Conclusion] Rhubarb retention enema combined with Western medicine to prevent acute severe cerebral vascular ulcer concurrent emergency satisfactory, no side effects, worthy of promotion.

关 键 词：急性重症脑血管并发应急性溃疡 大黄 保留灌肠 奥美拉唑 胃液指标 血浆内皮素 中西医结合治疗 随机平行对照研究 

分 类 号：R576[医药卫生—消化系统]