大黄醇提片治疗急性上消化道出血的临床疗效分析

作者	单位
焦东海	上海市香山中医医院
周鹤鸣	上海市卢湾区中心医院
刘训初	澳大利亚华夏中药研究贸易有限公司
葛国政	上海市香山中医医院
华宝芬	上海市香山中医医院
高雅萍	上海市香山中医医院
杜宝金	上海市香山中医医院
姚克裘	上海市卢湾区中心医院
沈学敏	上海市香山中医医院
章启尧	上海市香山中医医院
朱宗巍	上海市香山中医医院
邹徐晓	上海市香山中医医院
阮宜吾	上海市香山中医医院
甘自诚	上海市卢湾区中心医院

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中文摘要:

本文报道大黄醇提片治疗急性上消化道出血182例,总有效率为96.1%,平均止血时间2.8天。前瞻性与双盲对比研究后,表明它的止血显效率高于复方西药(P<0.01),同时克服了生大黄止血所引起的恶心呕吐及疗效不稳定等缺点,通过急性、亚急性毒性试验,遗传毒理学试验及对血管、胃蛋白酶、血液流变学、血小板、出凝血因子等多项指标的测定,证明大黄醇提片安全无毒,既有局部止血作用,又有全身性的血液稀释样止血作用,

英文摘要:

Alcoholic extract tablet of rhubarb(AETR)was used in treating 182 cases of upper GI hemor- rhage with total effective rate of 96.1% and hemostasis occurred in an average period of 2.8 days. The commonest cause of bleeding was peptic ulcer,and then gastritis,neoplasm of stomach,etc. Through retrospective,prospective and double blind comparative studies,it revealed that the marked effective rate of AETR was higher than that of Western medication(P<0.001),and equivalent to the simple recipe of rhubarb(P>0.05).The averse side effect of rhubarb such as nausea and vomiting,as well as the unstable therapeutic effect due to the variation in species of rhubarb was avoided.The mechanism of its hemostatic effect was:contraction of local blood ressel,reduction in permeability and motility of small intestine as well as the inhibtion of pepsin activity,which provided direct hemostatic effect on bleeding peptic ulcer.It elevated the plasma osmotic pressure which caused the hemostasis also.This was due to the dilution of blood.This conformed with the TCM theory—activating the blood circulation for hemostasis. Through pharmacological study,two hemostatic active principles were isolated,which contained abundent trace elements.These were relevant to hemostasis and hematopoiesis,and it provided material evidence for hemostatic effect of rhubarb.

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