解氏泻心汤预防食管胃静脉曲张破裂再出血临床观察  

Clinical Observation on Xieshi Xiexin Decoction in Preventing Rehemorrhages of Gastroesophageal Varices

作　　者：李思潮 李薇 LI Sichao;LI Wei(Department of Trad让ional Chinese Medicine,Dalian Sixth People's Hospital,Liaoning Province,Dalian 116013,China)

机构地区：[1]大连市第六人民医院中医科,辽宁大连116013

出　　处：《光明中医》2021年第17期2900-2904,共5页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：辽宁省自然科学基金(No.20180550310);辽宁省大连市医学科学研究计划项目(No.2017Z1003)。

摘　　要：目的研究解氏泻心汤联合内镜治疗预防食管静脉曲张破裂再出血的疗效。方法将40例食道胃底静脉曲张出血后肝硬化患者随机分为2组,对照组20例行内镜下序贯治疗,治疗组20例在胃镜序贯治疗的基础上加用解氏泻心汤加减,疗程半年,对比2组患者的食管静脉曲张治疗前后的根除率,再出血的次数,Child评分变化以及血红蛋白的变化。结果治疗组静脉曲张根除与基本消失率为95.0%,优于对照组的60.0%(P<0.05),随访半年,治疗组复发0例,对照组5例;2组患者肝功能治疗后均有改善,差异有统计学意义(P<0.05);2组Child-Pugh评分均有下降,治疗组前后差异有统计学意义(P<0.05);2组治疗后血红蛋白均上升,治疗组血红蛋白升高明显,差异有统计学意义(P<0.05)。结论2组患者食道胃底静脉曲张破裂再出血次数明显减少,Child-Pugh评分均得到改善,血红蛋白上升,静脉曲张根治率高,解氏泻心汤联合内镜治疗能够更好地预防食道胃底曲张出血。Objective To study the therapeutic effect of Xieshi Xiexin decoction combined with endoscopy on preventing rehemorrhage of esophageal varices.Methods 40 patients with cirrhosis after esophagogastric variceal hemorrhage were randomly divided into two groups.The control group of 20 cases was treated with endoscopic sequential therapy for half a year.The 20 patients in treatment group were treated with Xieshi Xiexin decoction on the basis of endoscopic sequential therapy.The eradication rate,frequency of rehemorrhage,the change of Child-Pugh score and hemoglobin were compared before and after treatment.Results The eradication and basic disappearance rate of varicose vein in the control group was 60.0%,and that in the treatment group was 95.0%,which was better than that in the control group(P<0.05).After six months of following-up,there were 0 cases of recurrence in the treatment group and 5 cases in the control group,and there was significant difference in each group before and after liver function treatment(P<0.05).The Child-Pugh score of both groups decreased,and there was significant difference before and after treatment in treatment group(P<0.05).Before and after treatment,hemoglobin of either group increased after treatment,and there was significant difference in treatment group(P<0.05).Conclusion In the two groups,the frequency of rehemorrhage was significantly reduced,the Child-Pugh score was improved,and the hemoglobin was increased,with good radical cure of varicose vein.Xieshi Xiexin decoction combined with endoscopy can effectively cease the hemorrhage of esophagogastric fundus varicosity.

关 键 词：吐血 便血 解氏泻心汤 食道胃底静脉曲张破裂再出血 中医药疗法 

分 类 号：R259[医药卫生—中西医结合]