| Objective:This study is to observe the upper gastrointestinal bleeding patients with acute non-variceal endoscopic spray about ShengJiZhiXueSan treatment, evaluated the hemostatic efficacy and clinical safety, in order to provide a new treatment method to stop bleeding. And to observe the efficacy of ShengJiZhiXueSan gastric bleeding rats models, clarify its mechanism of action, in order to provide the pharmacological basis for clinical application.Methods:Clinical research:The study period was from March 2014 to January 2016. The selected patients who met the inclusion criteria ANVUGIB is hospitalized in the Guangdong Provincial Second Chinese Medicine Hospital, and the dialectical type of Chinese Medicine was belong to excessive heat forcing blood. A total number of 60 patients were randomly divided into test (endoscopic spray of ShengJiZhiXueSan) and control (endoscopic spray of norepinephrine)groups,30 cases in each group. After pantoprazole acid therapy and nutritional support until the patients with stable vital signs, patients bleeding within 24 hours had drug endoscopic spray treatment. Postoperative patients in both groups are in the same conventional medical treatment as before. After endoscopic spray treatment, the operator must spend 5 min to observe and recorde two groups of patients’situation of immediate hemostasis; compared the immediate hemostasis rate, stool occult blood negative rate, the average hemostasis time, average hospitalization time, and total efficiency between two groups after treatment, and the data were analyzed statistically.Experimental study:40 Wistar rats were randomly divided into blank group (10 rats) and model group (30), model group were intragastric indomethacin to bleeding rats, rats after modeling were randomly divided into model group (10), positive control group(10), experimental group(10), experimental group were given ShengJiZhiXueSan solution by intragastric administration, positive control group had Yunnan Baiyao solution in the same way. Blank group and model group were given the same amount of normal saline, respectively. After modeling 0.5h and 3h each group had each fed 1 times. After 14h each group took abdominal aortic blood and removal of the stomach. All rats were observed bleed and clotting activated partial thromboplastin time, prothrombin time, thrombin time and bleeding gastric mucosal conditions.The results were statistically analyzed in order to explore hemostatic mechanism of ShengJiZhiXueSanResults:Clinical study:The immediate hemostasis rate:the test group timely hemostasis rate was 96.67%, it had a higher rate than the control group (76.67%) (P<0.05).The rebleeding rate:the test group had rebleeding rate of 3.33%, it had a lower degree than the control group (20%) (P<0.05).The rate of occult blood in stool converting negative:the test group had 90% fecal occult blood clearance rate, it had a better rate than the control group (60%) (P<0.05).The average hemostasis time:the test group was 31.43±7.67h hours, it had a shorter time than the control group (44.20±17.15 hours) (P<0.01).The time of hospitalization:the average hospitalization time of the test group was 6.40+1.482 days, it was shorter than the control group (7.267+1.680 days) (P<0.05).The total effective rate:the test group had 96.67% of the total efficiency.it was higher than the control group(83.33%) (P<0.05).Animal experiment:The prothrombin time:the average time in blank group was 11.020±1.698 seconds, the model group was 12.650 ±0.642 seconds, positive control group was 10.860 ±1.318 seconds, experimental group was 9.± 0.804 seconds, compared with the model group, the anothers were significantly lower (P<0.01); compared with the positive control group, the experimental group was significantly lower(P<0.05).The activated partial thromboplastin time:the blank group was 21.850+ 3.101 seconds, the model group was 25.980±3.602 seconds, positive control group was 20.900±2.428 seconds, experimental group was 20.540±2.208 seconds, the time of the model group was higher than the other three groups, with significant difference between two groups (P<0.01)The thrombin time:the blank group was 58.650 ±4.880 seconds, the model group was 64.810±3.704 seconds, positive control group was 54.190±3.990 seconds, experimental group was 52.730±5.865 seconds, the time of the model group was higher than the other three groups, with significant difference between two groups (P<0.01)Gastric mucosal bleeding point:the blank group had no gastric mucosal bleeding point, the model group was 30.400±4.858, experimental group was 16.200±3.615, positive control group was 10.800±2.378, compared with model group, other three groups were in a significantly lower level (P<0.01); compared with the positive control group, experimental group were in a significantly lower degree (P<0.01).Conclusion:Clinical studies show that:1. ShengJiZhiXueSan treatment to non-variceal upper gastrointestinal bleeding stop bleeding quickly, improve hemostatic rate, fecal occult blood negative rate, the overall efficiency,2. ShengJiZhiXueSan treatment to ANVUGIB can effectively reduce the average time to hemostasis and hospitalization time3. Not any adverse reactions were reported during the application of ShengJiZhiXueSan treatment.Animal experiments show that:1. ShengJiZhiXueSan can improve the function of blood coagulation in rats by initiating endogenous coagulation and exogenous coagulation2. ShengJiZhiXueSan can heal injured mucosa and reduce the bleeding point of the gastric mucosa in rats.In summary, it means ShengJiZhiXueSan with endoscopic spray hemostasishas had good clinical application security, it can be popularized in clinical application. |
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