ABSTRACT
Objective To observe the clinical effect of Qingre-Jiangni-Zhixue decoction combined with omeprazole sodium on acute non-variceal upper gastrointestinal bleeding. Methods A total of 64 patients with acute non-variceal upper gastrointestinal bleeding were divided into the observation group and control group according to random number table method, with 32 cases in each group. The control group was given the routine clinical treatment combined with omeprazole sodium, and the observation group was given Qingre-Jiangni-Zhixue decoction on the basis of the control group. After 7 days of continuous treatment, the basic clinical indexes (hemostasis time, blood transfusion volume, hospitalization time, 72 hours hemostasis rate, rebleeding rate), oxidative stress indexes (cortisol, malondialdehyde, antidiuretic hormone, blood glucose) and serum inflammatory factors (hs-CRP, TNF-α, IL-1β) were observed before and after treatment, and the clinical efficacy were evaluated. Results The total effective rate of the observation group was 90.6% (29/32), which was significantly higher than that of the control group 71.9% (23/32), with statistically significant (χ2=4.730, P=0.029). After treatment, the hemostasis time (18.86 ± 2.97 h vs. 29.12 ± 4.07 h, t=7.354),blood transfusion volume (559.32 ± 67.17 ml vs. 612.73 ± 75.81 ml, t=11.032),hospitalization time (5.43 ± 0.67 d vs. 9.26 ± 1.15 d, t=5.871) of the observation group were significantly lower than those of the control group (P<0.05). The 72 h hemostasis rate of the observation group was 3.1%, which was significantly lower than that of the control group 21.9%, with statistically significant (χ2=5.143, P<0.05). The rebleeding rate of the observation group was 96.9%, which was significantly higher than that of the control group 81.3% (χ2=4.010, P=0.045). After treatment, the cortisol level, the malondialdehyde level, blood glucose, antidiuretic hormone of the observation group were lower than those of the control group (t were 8.106, 4.976, 4.842, 5.093, all Ps<0.01). After treatment, the hs-CRP, serum TNF-α, serum IL-1β of the observation group were lower than those of the control group (t were 5.506, 4.983, 7.962, all Ps<0.01). Conclusions The application of Qingre-Jiangni-Zhixue decoction combined with omeprazole sodium can inhibit the expression of serum inflammatory cytokines in patients with acute non-variceal upper gastrointestinal bleeding, reduce the oxidative stress injury caused by bleeding, and improve the hemostatic efficiency.
ABSTRACT
Objective To observe the relationship between the peripheral blood IFN-γ secretion level and prognosis in the patients with early stage of acute cerebral hemorrhage.Methods Sixty-six inpatients with acute intracerebral hemorhage in the emergency department of this hospital from July 2015 to August 2016 were selected as the experimental group,and 60 healthy people in the physical examination center served as the blank control group.The peripheral blood mononuclear cells(PBMCs) and plasma were separated.The helper T cells(Th)1/Th2 eytokines(IFN-γ,IL-2,IL-4 and IL-10) were detected by using ELISA.The flow cytometry was used to detect intracellular cytokines;the disease condition change from 1 d of onset to 30 d in the experiment group was analyzed by using NIHSS.The relationship between the cytokines and prognosis on 30 d evaluated by NIHSS score was analyzed.Results The peripheral blood IFN-γ level had statistically significant difference between the two groups(P＜0.05),while the levels of IL-2,IL-4 and IL-10 had no statistical difference(P＞0.05).The peripheral blood IFN-γ secretion level during early stage in the experimental group was positively correlated with the prognosis(P＜0.05).Conclusion The increase of peripheral blood IFN-γ during early stage is correlated with the poor prognosis in the patients with acute intracerebral hemorrhage.