十全大补汤联合西药治疗急性上消化道出血后期贫血(气血两虚)随机平行对照研究  

Shiquan Dabu Decoction(十全大补汤) combined with Western Medicine in the Treatment of Anemia in Late stage of Acute Upper Gastrointestinal Bleeding(Qixue Liangxu/气虚两虚) Randomized Parallel Control Study

作　　者：李献良 LI Xianliang(The Department of Severe Medicine, Ruzhou People＇s Hospital,Ruzhou 467500,Henan,Chin)

机构地区：[1]汝州市人民医院重症医学科,河南汝州467500

出　　处：《实用中医内科杂志》2018年第5期46-49,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察十全大补汤联合西药治疗急性上消化道出血后期贫血疗效(气血两虚)。[方法]使用随机平行对照方法,将100例住院患者按病志号抽签方法随机分为两组。对照组50例促红素75~100IU/公斤·周^(-1),给药剂量依据贫血程度、年龄等调整,皮下注射;维生素B_(12) 1~4片/次,1次/d;叶酸5~10mg/次,3次/d;生长抑素0.25mg/h(微量注射泵);泮妥拉唑钠40mg+0.9%氯化钠注射液100m L,2次/d,静滴,1h内滴完。治疗组50例十全大补汤(人参6g,肉桂3g,川芎6g,地黄^(熟)12g,茯苓、白术各9g,甘草^(炒)3g,黄芪12g,当归、白芍各9g),水煎200m L,早晚分服,水肿加泽泻15g;脾胃弱加鸡内金10g,山楂15g;气虚加黄芪30g;西药治疗同对照组。连续治疗10d为1疗程。观测临床症状、网织红细胞、血小板、白细胞、血红蛋白、不良反应。治疗1疗程(10d),判定疗效。[结果]网织红细胞、血小板、白细胞、血红蛋白两组均有增加(P<0.01),治疗组增加多于对照组(P<0.01)。不良反应治疗组少于对照组(P<0.01)。[结论]十全大补汤联合西药治疗急性上消化道出血后期贫血,可明显改善生化指标,降低不良反应,值得推广。[Objective] To observe the effect of Shiquan Dabu decoction（十全大补汤） combined with western medicine on anemia in the late stage of acute upper gastrointestinal bleeding（Qixue Liangxu/气虚两虚）. [Methods] 100 cases of inpatients were randomly divided into two groups by random parallel control method. The control group was 50 cases of erythropoietin 75-100 IU/kg·week^-1, the dosage was adjusted according to the degree of anemia, age and so on, subcutaneous injection; vitamin B12 1-4 tablets/times, 1 times/d; folic acid 5 to 10 mg/, 3/d; somatostatin 0.25 mg/h（microinjection pump）; pantuprazole sodium 40 mg＋0.9% Sodium Chloride Injection 100 mL, 2/d, static drop, 1 h internal drop Finish. 50 patients in the treatment group（Renshen6 g, Rougui 3 g, Chuanxiong 6 g, Shudihuang 12 g, Fuling, Baizhu each 9 g, Chaogancao 3 g, Huangqi 12 g, Danggui, Baishao each 9 g）, water decocting 200 mL, morning and evening, edema plus Alisma orientalis 15 g; spleen and stomach weak plus chicken inner gold 10 g, hawthorn 15 g; Qi deficiency plus Astragalus membranaceus; western medicine in the same control group. The continuous treatment of 10 d was 1 courses. Clinical symptoms, reticulocytes, platelets, white blood cells, hemoglobin and adverse reactions were observed. The 1 course of treatment（10 d） was treated and the curative effect was determined. [Results] the two groups of reticulocytes, platelets, leukocytes and hemoglobin increased（P〈0.01）, and the treatment group increased more than the control group（P〈0.01）. The adverse reaction treatment group was less than the control group（P〈0.01）. [Conclusion] Shiquan Dabu decoction combined with western medicine in treatment of anemia in late stage of acute upper gastrointestinal bleeding can significantly improve biochemical indexes and reduce adverse reactions, which is worthy of promotion.

关 键 词：上消化道出血后期贫血 气血两虚 血证 虚劳 十全大补汤 促红素 维生素B12 叶酸 生长抑素 泮妥拉唑钠 微量注射泵 网织红细胞 血小板 白细胞 血红蛋白 中药复方 随机平行对照研究 

分 类 号：R556[医药卫生—血液循环系统疾病] R573.2[医药卫生—内科学]