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Objective:To investigate the clinical efficacy of modified Guipi Decoction combined with omeprazole in the treatment of acute non-variceal upper gastrointestinal bleeding (ANVUGIB) with failure of the spleen to control blood vessels syndrome.Methods:Prospective cohort study. A total of 120 patients from January 2018 to December 2021 Taihe County Hospital of Traditional Chinese Medicine with ANVUGIB of failure of the spleen to control blood vessels syndrome were selected, and the patients were divided into observation group and control group according to the random number table method, with 60 cases in each group. The control group was treated with a large dosage of proton pump inhibitor (omeprazole injection was injected intravenously first, and then omeprazole enteric coated tablets were taken); the observation group took Guipi Decoction on the basis of the control group, and both groups were treated for 7 days. TCM syndrome score, Hemoglobin (Hb) and hematocrit (HCT) levels were measured by colorimetry before and after the treatment. BUN was detected by urease glutamate dehydrogenase method. Prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) levels were detected by immunoturbidimetry. The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results:Two patients in the observation group and two patients in the control group dropped out of the study. After treatment, the scores of main symptoms, secondary symptoms and total scores in the observation group were lower than those in the control group ( t values were respectively 10.73, 4.45, 7.98, P<0.05). After treatment, the levels of HCT [(41.25 ± 5.03)% vs. (38.19 ± 5.26)%, t=2.95], Hb [(81.09 ± 5.23) g/L vs. (78.39 ± 5.37) g/L, t=2.74] in the observation group were higher than those in the control group ( P<0.01), and BUN [(4.38±0.96) mmol/L vs. (5.39 ± 1.13) mmol/L, t=5.19] was lower than that in the control group ( P<0.01); PT [(12.48 ± 0.67) s vs. (13.22 ± 0.73) s, t=5.69], APTT [(24.66 ± 2.29) s vs. (27.78 ± 2.04) s, t=7.75] were lower than those in the control group ( P<0.01), and FIB [(3.68 ± 0.62) g/L vs. (3.41 ± 0.74) g/L, t=2.13] level was higher than that in the control group ( P<0.05). The total effective rate of the observation group was 93.1% (54/58), and that of the control group was 79.3% (46/58), with statistical significance ( χ2=4.64, P=0.031). During the treatment, the incidence of adverse reactions in the control group was 3.4% (2/58), while that in the observation group was 1.7% (1/58), without statistical significance ( χ2=0.34, P=0.559). Conclusion:High-dosage omeprazole treatment with the addition of internal administration of Guipi Decoction can significantly improve coagulation function, correct the signs and symptoms associated with insufficient blood volume in the body circulation, improve hemostatic efficiency, and reduce the risk of bleeding in patients with ANVUGIB, without increasing the risk of patient safety with the drug.
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Objective To evaluate the safety and efficiency of composite microporous polysaccharide pow-der in non-varicose veins of gastrointestinal bleeding treatment. Methods We retrospectively analyzed 35 cases of the past 2 years in this hospital. Those patients were clinical diagnosed with non-varicose veins of gastrointestinal bleeding and received composite microporous polysaccharide powder in hemostasis. Results All 35 patients stopped bleeding after treatment with combined treatment of composite microporous polysaccharide powder spray. All vital signs were smooth and steady such as oxyhemoglobin saturation and heart rate,without complications like irritability,deterioration of inflammation and delayed hemorrhage. Conclusion The combined utilization of com-posite microporous polysaccharide powder provided rapid and effective hemostasis in therapy of non-varicose veins of gastrointestinal bleeding,which is an effective,simple and safe operation and to be worth of being generalized.
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Objective To explore the risk factors affected the timing of endoscopic examination in nonvariceal upper gastrointestinal bleeding (NVUGIB).Methods From January 2001 to December 2011 , 441 patients diagnosed as NVUGIB under endoscope were enrolled,and they were divided into the group receiving endoscopy within 24 hours (233 cases)and the group receiving endoscopy beyond 24 hours (208 cases).The demographic and clinical characteristics of the two groups were analyzed.Student′s t test was used for measurement data comparison and chi-square test for numerical data.Logistic regression analysis was used to analyze the multivariate factors which influenced the timing of endoscopy examination.Results The rates of complication in the group receiving endoscopy within 24 hours and the group receiving endoscopy beyond 24 hours were 9.0% (21/233)and 19.7% (41/208),and the difference was statistically significant (χ2 =10.411 ,P =0.001 ).The mean systolic blood pressure were (118 ±19 )and (122±19)mmHg (1 mmHg=0.133 kPa),respectively,and the difference was statistically significant (t=2.099,P = 0.036 ).On admission the mean hemoglobin were (98 ± 27 )and (93 ± 28 )g/L, respectively,and the difference was not statistically significant (t=1 .640,P =0.102).The mortality rate were 1 .3% (3/233 )and 5 .3% (11/208 ),respectively,and the difference was statistically significant (χ2 =5 .723,P =0.017).With multivariate Logistic regression,multivariate factors analysis indicated that complication was the main factor influenced the timing of endoscopy examination (OR =2.710,95 %CI :1 .502 to 4.899,P 0.05).Conclusion Complication is a risk factor in the timing delayed endoscopy.