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目的:观察紫稔止血汤联合奥美拉唑治疗消化性溃疡出血(PUB)的临床疗效及作用机制。方法:将90例PUB患者随机按数字表法分为对照组和中西医结合组各45例。对照组采用注射用奥美拉唑钠,40 mg/次,静脉滴注,1次/d。中西医结合组在对照组治疗的基础上采用紫稔止血汤内服。两组疗程均为7 d。记录出血停止时间,住院时间;进行治疗前后主要症状、体征评分;检测治疗前后血小板α-膜颗粒蛋白(GMP-140),血栓素B2(TXB2),和6-酮前列腺素F1α(6-Keto-PGF1α)水平。结果:经Ridit分析,中西医结合组临床疗效优于对照组(P<0.05);中西医结合组出血停止时间和平均住院时间均短于对照组(P<0.01);治疗后中西医结合组黑便、胃脘疼痛、倦怠乏力、头晕、心悸和面色等症状、体征评分均低于对照组(P<0.01);治疗后两组TXB2水平升高,6-Keto-PGF1α水平下降(P<0.01),治疗后对照组GMP-140变化不明显,中西医结合组GMP-140较治疗前升高(P<0.01);治疗后中西医结合组GMP-140和TXB2水平高于对照组,6-Keto-PGF1α水平低于对照组(P<0.01)。结论:紫稔止血汤联合奥美拉唑治疗消化性溃疡出血,能缩短止血时间和住院时间,能改善临床症状,其临床疗效优于奥美拉唑。
Objective: To observe the clinical efficacy and mechanism of purpuric hemostatic soup combined with omeprazole in the treatment of peptic ulcer bleeding (PUB). Methods: Ninety cases of PUB were randomly divided into control group and 45 cases of Integrative Medicine group according to the digital table method. The control group was omeprazole sodium for injection, 40 mg / time, intravenous infusion, 1 time / d. Integrative Medicine group in the control group based on the treatment of purple astringent soup oral administration. The two courses of treatment were 7 d. The bleeding time and length of hospital stay were recorded. The main symptoms and signs were recorded before and after treatment. The levels of GMP-140, TXB2 and 6-Keto -PGF1α) levels. Results: The Ridit analysis showed that the clinical efficacy of the integrated traditional Chinese and western medicine group was better than that of the control group (P <0.05); the stopping time and the average length of hospital stay of the integrated traditional Chinese and western medicine group were shorter than those of the control group (P <0.01) The levels of TXB2 and 6-Keto-PGF1α in the two groups were significantly lower than those in the control group (P <0.01). After treatment, the levels of TXB2 and 6-Keto-PGF1α were decreased (P < 0.01). After treatment, the GMP-140 level in the control group was not significantly changed. The GMP-140 level in the combination group was significantly higher than that before treatment (P <0.01). After the treatment, the levels of GMP-140 and TXB2 in the TCM-WM group were higher than those in the control group -Keto-PGF1α levels were lower than the control group (P <0.01). Conclusion: Zizhurestin Decoction combined with omeprazole in the treatment of peptic ulcer bleeding can shorten the time to stop bleeding and hospital stay, can improve clinical symptoms, its clinical efficacy is better than omeprazole.