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目的:探讨泻心汤合十灰散联合泮托拉唑治疗上消化道出血患者临床疗效。方法:截选86例诊断为上消化道出血患者按照随机数字表法分为对照组(泮托拉唑40mg+0.9%氯化钠溶液250ml静脉滴注)与治疗组(于对照组治疗基础上采用泻心汤合十灰散治疗),各43例。评价两组临床疗效,并记录有效止血时间、24h再出血率,评价两组患者治疗前后临床各项中医证候积分变化,统计两组治疗期间不良反应。结果:治疗后治疗组患者治疗总有效率90.7%,明显高于对照组69.8%,P<0.05;治疗组有效止血时间(18.9±5.1)h明显短于对照组(30.7±6.9)h,P<0.05;治疗组24h再出血率4.7%明显低于对照组18.6%,P<0.05。两组患者各项中医证候积分较治疗前明显下降,治疗组治疗后各项中医证候积分明显低于对照组,P<0.05;治疗组不良反应率4.7%,明显少于对照组20.9%,P<0.05。结论采用泮托拉唑联合泻心汤合十灰散治疗上消化道出血疗效显著且安全。
Objective: To investigate the clinical efficacy of Xiexin Decoction combined with Shifan San and Pantoprazole in the treatment of patients with upper gastrointestinal hemorrhage. Methods: A total of 86 patients diagnosed as upper gastrointestinal bleeding were randomly divided into control group (intravenous infusion of pantoprazole 40mg + 0.9% sodium chloride solution 250ml) and treatment group (on the basis of the control group The use of Xie Xin Tang Decoction treatment), each 43 cases. The clinical curative effect of both groups was evaluated. The effective time of hemostasis and the rate of rebleeding for 24 hours were recorded. The changes of TCM syndrome scores before and after treatment were evaluated. The adverse reactions of the two groups were statistically analyzed. Results: After treatment, the total effective rate of the treatment group was 90.7%, significantly higher than that of the control group (69.8%, P <0.05). The effective hemostatic time (18.9 ± 5.1) h in the treatment group was significantly shorter than that in the control group (30.7 ± 6.9) h <0.05; 24h rebleeding rate in treatment group 4.7% was significantly lower than that in control group 18.6%, P <0.05. The scores of TCM syndromes in both groups were significantly lower than those before treatment. The score of TCM syndromes in the treatment group was significantly lower than that in the control group (P <0.05). The adverse reaction rate in the treatment group was 4.7%, significantly less than that in the control group (20.9% , P <0.05. Conclusions Pantoprazole combined with Xiexin Decoction and Decoction for Treating Upper Gastrointestinal Hemorrhage is effective and safe.