| Objective: To observe the clinical effect of endoscopy combined with traditional Chinese medicine in the treatment of hemorrhage from esophageal gastric varices of liver cirrhosis.Methods: Collected patients with liver cirrhosis and esophageal varices who underwent endoscopic treatment in the Department of Liver Cirrhosis,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine from April 2015 to February 2021.After endoscopic treatment,all patients were prescribed non-selectiveβ-blocker carvedilol 10 mg/d to reduce portal pressure.Patients who take Chinese medicine treatment(including proprietary Chinese medicines and Chinese herbal medicines)at the same time are defined as the Chinese and Western medicine group,and those who are not taking Chinese medicine treatment are defined as the Western medicine group.After treatment,the patients were followed up with regular endoscopy to record the changes of esophageal and gastric fundus varices and portal hypertensive gastropathy,rebleeding and death under endoscopy,and analyze the effect of endoscopy combined with traditional Chinese medicine in preventing rebleeding.A total of 128 patients underwent endoscopic treatment,16 cases of malignant tumors were excluded,112 cases met the criteria for inclusion and exclusion,108 cases were finally followed up,and 4 cases were lost to follow-up(2cases each in the Chinese and Western medicine group and the Western medicine group).There were 59 cases in the western medicine group and 49 cases in the western medicine group.All patients were treated with endoscopy.After treatment,gastroscopy was reviewed once a month.If there are still varicose veins,endoscopic treatment is continued until the varicose veins are eliminated.Follow-up again at the 3rd,6th,and12 th month after the varicose vein is eliminated.If there is a recurrence during the period,endoscopic treatment will be performed again according to the condition of the varicose vein.If there is no recurrence,12 months later The gastroscope is reviewed once a year.The incidence of rebleeding is the main efficacy evaluation index,and the elimination rate of esophageal varices,the recurrence rate,the number of treatments required to eliminate varices,the improvement rate of portal hypertension gastric disease,and the mortality rate are the secondary efficacy evaluation indexes.Analyze the difference in curative effect between Chinese and Western medicine group and Western medicine group.Results:(1)The overall rebleeding rate of the Chinese and Western medicine group was lower than that of the Western medicine group(14% vs.24%),but the difference was not statistically significant(P> 0.05),while the Chinese and Western medicine group was 12-24 after endoscopic treatment The monthly rebleeding rate was significantly lower than that of the western medicine group(2% vs.12%,P = 0.045).(2)The mortality rate of rebleeding in the Chinese and Western medicine group was significantly lower than that in the Western medicine group(2% vs.12%,P = 0.045).(3)The total effective rate of portal hypertensive gastropathy in the Chinese and Western medicine group was significantly higher than that in the Western medicine group(90% vs.77%,P = 0.04).(4)The elimination rate of varicose veins in the Chinese and Western medicine group was higher than that in the Western medicine group(53% vs.37%),but the difference was not statistically significant(P> 0.05).(5)The recurrence rate of varicose veins in the western medicine group was lower than that in the traditional Chinese medicine group(0% vs.16%),but the difference was not statistically significant(P> 0.05);the two groups also had differences in the number of treatments required to eliminate varicose veins No statistical significance(P> 0.05).Conclusions: Endoscopy combined with traditional Chinese medicine treatment can significantly reduce the incidence of rebleeding in patients with esophageal gastric varices bleeding from 12 to 24 months,can significantly reduce the mortality rate of esophageal varices rebleeding,and can significantly improve the degree of portal hypertensive gastric disease,Provide a new treatment idea for the comprehensive treatment of cirrhosis of the liver with esophagogastric varices bleeding by endoscopy combined with Chinese medicine. |
