改良黄土汤联合西药治疗急性上消化道出血的临床效果  

Clinical Effect of Modified Huangtu Decoction Combined with Western Medicine in the Treatment of Acute Upper Gastrointestinal Hemorrhage

作　　者：谢顺龙 周桂秀 胡丙根 周裕兰 黄志明 XIE Shunlong;ZHOU Guixiu;HU Binggen;ZHOU Yulan;HUANG Zhiming(Department of Gastroenterology of Integrative Chinese and Western Medicine,the Fifth Hospital of Jianqiang,Fuzhou,Fuzhou 344000,China;不详)

机构地区：[1]抚州健强第五医院中西医结合消化内科,江西抚州344000 [2]抚州健强第五医院护理部,江西抚州344000 [3]抚州健强第五医院胃镜室,江西抚州344000 [4]抚州健强第五医院中医科,江西抚州344000

出　　处：《中国医学创新》2024年第26期106-110,共5页Medical Innovation of China

基　　金：2023年度抚州市第一批指导性科技计划项目(60号)。

摘　　要：目的:探究改良黄土汤联合奥美拉唑及口服去甲肾上腺素治疗急性上消化道出血的临床效果。方法:回顾性分析抚州健强第五医院2022年5月—2023年8月收治的急性上消化道出血患者80例的病历资料,根据治疗方案不同分为对照组(n=38)和观察组(n=42)。对照组给予奥美拉唑及口服去甲肾上腺素治疗,观察组在此基础上加用改良黄土汤。比较两组临床疗效、止血效果、止血时间、血压稳定时间及住院时间,以及治疗前后血清白细胞介素-1β(IL-1β)、二胺氧化酶(DAO)、超敏C反应蛋白(hs-CRP)、胃泌素(GAS)水平,并记录不良反应发生情况。结果:观察组临床总有效率为92.86%,高于对照组的76.32%,差异有统计学意义(P<0.05);观察组治疗24、72 h的止血成功率均高于对照组,止血时间、血压稳定时间均早于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05);与治疗前比较,治疗7 d后两组血清GAS、DAO、IL-1β、hs-CRP水平均下降,且观察组以上指标均低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:急性上消化道出血患者应用改良黄土汤联合奥美拉唑及口服去甲肾上腺素治疗,可显著降低各炎症指标,快速止血、缓解患者临床症状,缩短治疗时间,疗效显著且安全性好。Objective:To investigate the clinical effect of modified Huangtu Decoction combined with Omeprazole and oral Norepinephrine in the treatment of acute upper gastrointestinal hemorrhage.Method:The medical records of 80 patients with acute upper gastrointestinal hemorrhage admitted to the Fifth Hospital of Jianqiang,Fuzhou from May 2022 to October 2023 were retrospectively analyzed,and they were divided into control group(n=38)and observation group(n=42)according to different treatment schemes.The control group was treated with Omeprazole and oral Norepinephrine,and the observation group was treated with modified Huangtu Decoction on this basis.The clinical efficacy,hemostatic effect,hemostatic time,blood pressure stabilization time,hospital stay,the levels of interleukin-1β(IL-1β),diamine oxidase(DAO),hypersensitive C reactive protein(hs-CRP)and gastrin(GAS)before and after treatment were compared between the two groups,and the occurrence of adverse reactions were recorded.Result:The total clinical effective rate of the observation group was 92.86%,which was higher than 76.32% of the control group,the difference was statistically significant(P<0.05).The success rate of hemostasis in the observation group were higher than those in the control group at 24 and 72 h of treatment,and the hemostasis time,blood pressure stabilization time were earlier than those in the control group,hospital stay was shorter than that in the control group,the differences were statistically significant(P<0.05).Compared with before treatment,the levels of serum GAS,DAO,IL-1βand hs-CRP in both groups were decreased after 7 days of treatment,and the above indexes in observation group were lower than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of modified Huangtu Decoction combined with Omeprazole and oral Norepinephrine in the treatment of acute upper gastrointestinal hemorrhage can significantly reduce the inflammatory in

关 键 词：急性上消化道出血 改良黄土汤 奥美拉唑 去甲肾上腺素 

分 类 号：R573.2[医药卫生—消化系统]