裸花紫珠颗粒联合奥曲肽治疗肝硬化上消化道出血的临床研究

目的探讨裸花紫珠颗粒联合奥曲肽治疗肝硬化上消化道出血的临床疗效。方法选取2018年3月-2019年3月在琼海市人民医院治疗的肝硬化上消化道出血患者88例,根据用药的差别分为对照组(44例)和治疗组(44例)。对照组患者静脉滴注醋酸奥曲肽注射液,0.1 mg加入生理盐水250 mL,1次/d;治疗组在对照组的基础上口服裸花紫珠颗粒,3 g/次,4次/d。两组患者均经4d治疗。观察两组患者临床疗效,同时比较治疗前后两组患者门静脉血流、脾静脉血流、门静脉内径、脾静脉内径、止血时间、输血量、肝静脉游离压(FHVP)、肝静脉锲入压(WHVP),及血清超敏C反应蛋白(hs-CRP)、血管紧张素Ⅱ(AT-II)、肾素活性(PRA)、抗利尿激素(ADL)和一氧化氮(NO)水平。结果治疗后,对照组和治疗组临床有效率分别为81.82%和97.73%,两组比较差异具有统计学意义(P<0.05)。经治疗,两组门静脉血流、脾静脉血流、门静脉内径及脾静脉内径均明显减小(P<0.05),且治疗组明显小于对照组(P<0.05)。经治疗,治疗组患者止血时间明显短于对照组(P<0.05),且输血量明显小于对照组(P<0.05)。经治疗,两组患者FHVP、WHVP均明显降低(P<0.05),且治疗组患者降低更显著(P<0.05)。经治疗,两组患者血清hs-CRP、AT-II、NO、PRA、ADL水平均明显降低(P<0.05),且治疗组明显低于对照组(P<0.05)。结论裸花紫珠颗粒联合奥曲肽治疗肝硬化上消化道出血疗效好,可改善机体血流动力学指标,具有一定的临床推广应用价值。

Clinical study on Luohua Zizhu Granules combined with octreotide in treatment of upper gastrointestinal hemorrhage due to cirrhosis

Objective To investigate the clinical effect of Luohua Zizhu Granules combined with octreotide in treatment of upper gastrointestinal hemorrhage due to cirrhosis. Methods Patients (88 cases) with upper gastrointestinal hemorrhage due to cirrhosis in Qionghai People''s Hospital from March 2018 to March 2019 were divided into control (44 cases) and treatment (44 cases) groups based on different treatments. Patients in the control group were iv administered with Octreotide Acetate Injection, 0.1 mg added into normal saline 250 mL, once daily. Patients in the treatment group were po administered with Luohua Zizhu Granules on the basis of the control group, 3 g/time, four times daily. Patients in two groups were treated for 4 d. After treatment, the clinical efficacy was evaluated, and the blood flow velocity of portal vein and splenic vein, diameter of portal vein and splenic vein, hemostasis time and blood transfusion volume, FHVP, WHV, and the serum level of hs-CRP, AT-II, NO, PRA, and ADL in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.82% and 97.73% respectively, and there were differences between two groups (P<0.05). After treatment, the blood flow velocity of portal vein and splenic vein, diameter of portal vein, and splenic vein in two groups were significantly decreased (P<0.05), and these hemodynamic parameters in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the hemostasis time in the treatment group was significantly shorter than that in the control group (P<0.05), and the blood transfusion volume was significantly less than that in the control group (P<0.05). After treatment, the FHVP and WHVP in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the serum level of hs-CRP, AT-II, NO, PRA, and ADL in two groups were significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion Luohua Zizhu Granules combined with octreotide in treatment of upper gastrointestinal hemorrhage due to cirrhosis has good clinical effect, can improve hemodynamic parameters, and has a certain clinical application value.