生大黄联合西咪替丁治疗脑卒中并发应激性上消化道出血的临床观察

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目的:探讨生大黄联合西咪替丁治疗脑卒中并发应激性上消化道出血的临床疗效。方法:选择84例脑卒中并发应激性上消化道出血患者为研究对象,按照随机原则分为治疗组和对照组。两组均接受常规脑卒中治疗,并给予西咪替丁药物治疗;治疗组在此基础上,给予口服生大黄粉,连续治疗7 d,分析比较两组治疗前后临床症状及体征改善情况,并进行疗效评估。结果:治疗组总有效率为92.8%,显著高于对照组的71.4%,组间差异有统计学意义(P<0.05);经治疗后,两组胃液p H均出现显著升高(P<0.05),且治疗组治疗后不同时间点的胃液p H均显著高于对照组(P<0.05);治疗组大便潜血试验平均转阴时间为(39.8±4.3)h,显著低于对照组平均转阴时间(72.5±5.1)h,差异有统计学意义(P<0.05);治疗组大便潜血试验转阴率为92.8%,对照组转阴率为69.0%,差异有统计学意义(P<0.05)。结论:生大黄联合西咪替丁治疗脑卒中并发的应激性上消化道出血,安全可靠,疗效显著。 Objective: To investigate the clinical efficacy of rhubarb combined with cimetidine in the treatment of stress-induced upper gastrointestinal bleeding complicated by stroke. Methods: Eighty-four stroke patients with stress-induced upper gastrointestinal hemorrhage were selected as study subjects and divided into treatment group and control group randomly. Both groups received conventional stroke treatment and cimetidine drug treatment. On the basis of this, the treatment group was treated with oral administration of rhubarb powder for 7 consecutive days, and the clinical symptoms and signs of the two groups were compared before and after treatment Efficacy evaluation. Results: The total effective rate of the treatment group was 92.8%, which was significantly higher than that of the control group (71.4%, P <0.05). After treatment, p H in both groups increased significantly (P < 0.05). The p H of gastric juice in the treatment group at different time points after treatment was significantly higher than that in the control group (P <0.05). The average time of fecal occult blood test in the treatment group was (39.8 ± 4.3) h, which was significantly lower than that of the control group (72.5 ± 5.1) h, the difference was statistically significant (P <0.05). In the treatment group, the fecal occult blood test negative conversion rate was 92.8% and the control group negative conversion rate was 69.0%, the difference was statistically significant (P < 0.05). Conclusion: Rhubarb combined with cimetidine in the treatment of stroke complicated by stress of upper gastrointestinal bleeding, safe and reliable, significant effect.
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