[目的]探讨内镜下氩离子凝固术(APC)联合自拟止血一号方治疗非静脉曲张性上消化道出血的临床疗效。[方法]对120例确诊为非静脉曲张性上消化道出血患者,在内镜下行APC止血,予以质子泵抑制剂、静脉补液等常规治疗后,随机分为2组:治疗组(60例),在常规治疗的基础上加用自拟止血一号方煎剂口服;对照组(60例)仅予常规治疗。比较2组治疗总有效率及再出血率、死亡率、输血量、平均住院日、住院费用等指标。[结果]治疗组和对照组的总有效率分别为96.61%和88.33%(P〈0.05);再出血率为3.33%和11.67%(P〈0.05);死亡率为1.67%和5.00%(P〈0.05);输血量为(2.34±2.05)U和(4.35±3.45)U(P〈0.05);平均住院日为(10.59±4.88)d和(15.79±8.00)d(P〈0.05);住院费用为(8.16±1.43)千元和(13.35±1.91)千元(P〈0.05)。[结论]APC联合中药治疗上消化道出血是一种疗效显著、死亡率及输血量低、住院天数短、经济实惠的治疗方法。
[Objective]To study the effect of argon plasma coagulation(APC)combined with hemostatic formula on the varices upper gastrointestinal bleeding. [Methods] One-hundred and twenty patients diagnosed as the varices upper gastrointestinal bleeding were treated with APC under endoscopy,and then received conventional therapy, e. g. PPI, intravenous rehydration, etc. The patients were randomly divided into two groups, treatment group(n= 60)administrated with hemostatic formula besides routine treatment and the control group (n = 60)with conventional treatment. Total effective rate,mortality, rehemorrhage blood transfusions, average days in hospital and hospitalization expenses of the two groups were compared respectively, [Results]The total effective rate was 96. 61% in the treatment group and 88. 33% in the control group(P〈0. 05); the rebleeding rate was 3.33% and 11.67% respectively(P〈0.05) ;the mortality was 1.67% and 5.00%(P〈0.05) ;the amount of blood transfugion was(2.34±2.05)U and(4. 35±3.45)U(P〈 0.05) ;the hospital stay was(10. 59±4.88)d,and(15.79±8.00)d(P〈0.05) ;the cost was(8. 16± 1.43 ) and( 13.35 ± 1.91 ) thousand yuan RMB(P〈0. 05). [Conclusion]The combined application of APC with TCM achieved good effect, decreasing the mortality and the blood transfusion and shortening the hospital stay.