生肌止血散内镜下喷洒治疗急性非静脉曲张性上消化道出血30例总结  

Clinical effect ofendoscopic spray of Shengji Zhixue powder in treatment of acute non-variceal upper gastrointestinal bleeding:an analysis of 30 cases

作　　者：钟毅[1] 张焕兰 江南燕[1] 漆娜[1] 赖洁珊[1] ZHONG Yi;ZHANG Huan- lan;JIANG Nan- yan;QI Na;LAI Jie- shan(Guangdong Second Provincial Traditional Chinese Medicine Hospital, Guangzhou 510095, Guangdong, China;Shuikou People＇ s Hospital, Huizhou 516001, Guangdong, China)

机构地区：[1]广东省第二中医院,广东广州510095 [2]广东省惠州市水口人民医院,广东惠州516001

出　　处：《湖南中医杂志》2017年第10期13-16,共4页Hunan Journal of Traditional Chinese Medicine

基　　金：广东省中医药局立项课题(编号:20141019)

摘　　要：目的:对热盛迫血型急性非静脉曲张性上消化道出血(ANVUGIB)患者进行内镜下喷洒生肌止血散治疗,观察其止血疗效及临床安全性。方法:将60例热盛迫血型ANVUGIB患者随机分为2组各30例,2组患者术前均予西医常规治疗,待生命体征平稳后,于出血24h内,治疗组予胃镜下喷洒生肌止血散,对照组喷洒重酒石酸去甲肾上腺素注射液,内镜下治疗后2组均继续采用西医常规治疗方案。对2组治疗后的即时止血率、再出血率、大便潜血转阴率、平均止血时间、平均住院时间、总有效率等数据进行记录比较。结果:治疗组总有效率为96.67%,显著高于对照组的83.33%;即时止血率为96.67%,优于对照组的76.67%;再出血率为3.33%,显著低于对照组的20.00%;大便潜血转阴率为90.00%,明显高于对照组的60.00%;平均止血时间为(31.43±7.67)h,显著短于对照组的(44.20±17.15)h;平均住院时间为(6.40±1.43)d,明显短于对照组的(7.27±1.68)d;2组各项指标差异均有统计学意义(P<0.05)。治疗组未出现不良反应。结论:内镜下喷洒生肌止血散治疗热盛迫血型ANVUGIB,能迅速止血,提高止血率、大便转阴率及治疗的总有效率,并可缩短止血时间及住院时间,且安全性高。Objective：To investigate the hemostatic effect and clinical safety of endoscopic spray of Shengji Zhixue powder in the treatment of acute non - variceal upper gastrointestinal bleeding （ ANVUGIB ） with the syndrome of heat excess andblood stasis. Methods ： A total of 60 patients with ANVUGIB with the syndrome of heat excess andblood stasis were randomly divided into treatment group and control group, with 30 patients in each group. The patients in both groups were given conventional Western medicine treatment before surgery;after theirvital signs became stable ,the patients in the treatment group were givenendoscopic spray of Shengji Zhixue powderwithin 24 hours after bleeding, and those in the control group were given endoscopic spray ofnoradrenaline bitartrate injection within 24 hours after bleeding;both groups were given conventional Western medicine treatment after endoscopic treatment. The two groups were compared in terms of immediate hemostasis rate, rebleeding rate, clearance rate ofoccult blood in stool, mean time to hemostasis, mean hospital stay, and overall response rate after treatment. Results：The treatment group had a significantly higher overall response rate than the control group （96.67% vs 83.33% ,P 〈 0. 05）. Compared with the control group, the treatment group had a significantly higher immediate hemostasis rate （ 96.67% vs 76.67% , P 〈 0. 05 ）, a significantly lower reblecding rate （ 3.33% vs 20.00% ,P 〈 0. 05 ） , a significantly higher clearance rate ofoccult blood in stoo1（90. 00% vs 60.00% ,P 〈 0.05 ） , a significantly shorter mean time to hemostasis （31.43 ±7.67h vs 44. 20 ± 17.15h, P 〈 0. 05 ）, and significantly shorter mean hospital stay（6.40 ± 1.43d vs 7.27 ± 1.68d,P 〈 0. 05 ）. No patient in the treatment group experienced adverse reactions. Conclusion：In the treatment of ANVUGIB with the syndrome of heat excess andblood stasis,endoscopic spray of Shengji Zhixue powder can rapidly stop bleeding, improve hemostasis rate, clearance rat

关 键 词：非静脉曲张性上消化道出血 热盛迫血证 生肌止血散 内镜下喷洒 

分 类 号：R259.732[医药卫生—中西医结合]