摘要
目的观察中西医结合治疗顽固性鼻出血的临床疗效。方法90例顽固性鼻出血患者随机分为鼻内镜组、阿莫西林组、一清胶囊组，每组30例。鼻内镜组使用鼻内镜微波治疗；阿莫西林组在鼻内镜微波治疗后服用阿莫西林胶囊，每次0．5g，每天3次，连服3～5天；一清胶囊组在阿莫西林组治疗基础上再服用一清胶囊，每次1g，每日3次，连服2周。对患者治疗前后尿激酶型纤溶酶原激活物（uPA）及其受体（uPAR）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）及血浆纤维蛋白原水平（FIB）进行检测。同时观察临床疗效、治愈次数。结果一清胶囊组临床疗效总有效率90．O％，显著高于鼻内镜组的63．3％（P〈0．05），与阿莫西林组的80．0％比较，差异无统计学意义（P〉0．05）。一清胶囊组一次治愈率显著高于鼻内镜组与阿莫西林组（P〈0．05）。治疗前后鼻内镜组uPA、PT、FIB，阿莫西林组uPA、PT、APTT、FIB，一清胶囊组uPA、uPAR、PT、APTI、TT及FIB比较差异均有统计学意义（P〈0．05）；治疗后一清胶囊组uPA、uPAR、APTT、TT、FIB与鼻内镜组及阿莫西林组，PT与鼻内镜组比较差异均有统计学意义（P〈0．05）。结论中西医结合治疗顽固性鼻出血可提高临床疗效，改善凝血指标。
Objective To observe the efficacy of integrative medicine for refractory epistaxis. Methods Ninety cases of refractory epistaxis were randomized into the nasal endoscopy group, amoxicillin group and Yiqing Capsules group, with 30 in each. The nasal endoscopy group was given nasal endoscopy microwave treatment. The amoxicillin group was given 0.5 g of amoxicillin three times daily for 3 to 5 days on the basis of nasal endoscopy group. The Yiqing Capsules group was given 1 g of Yiqing Capsules three times daily for 2 weeks on the basis of arnoxicillin group. The levels of urokinase plasminogen activator （uPA）, uPA receptor （uPAR）, prothrombin time （FF）, activated par- tial thromboplastin time （AFFF）, thrombin time （Tr） and FIBrinogen （FIB） were detected before and after treat- ment. The efficacy and cure rate were observed. Results The total effective rate of Yiqing Capsules group and na- sal endoscopy group was 90.0% and 63.3% respectively, with a significant difference between groups （P 〈 0.05）. The total effective rate of amoxicitlin group was 80.0%, with no significant difference comparing with Yiqing Capsules group （P 〉 0. 05 ）. The one-time cure rate in the Yiqing Capsules group was significantly higher than that in the nasal endoscopy group and amoxicillin group （P 〈 0.05 ）. After treatment, the levels of uPA, PT and FIB were significant- ly improved in the nasal endoscopy group, the levels of uPA, PT, APTT and FIB were significantly improved in the amoxicillin group and the levels of uPA, uPAR, PT, APTT, TT and FIB were significantly improved in the Yiqing Capsules group （ P 〈 0.05 ）. Comparing with the nasal endoscopy group and amoxicillin group, the levels of uPA, uPAR, AFFF, TT and FIB were significantly improved in the Yiqing Capsules group after treatment （ P 〈 0. 05 ）. Comparing with the nasal endoscopy group, the PT level in the Yiqing Capsules group was significantly improved （P 〈 0.05）. Conclusion Integrative medicine is effective for refractory epistaxis. It can improve clinical outcomes and coagulation.
出处
《中医杂志》
CSCD
北大核心
2014年第17期1487-1490,共4页
Journal of Traditional Chinese Medicine
