目的 探討裸花紫珠顆粒聯(lián)合奧曲肽治療肝硬化上消化道出血的臨床療效。方法 選取2018年3月-2019年3月在瓊海市人民醫(yī)院治療的肝硬化上消化道出血患者88例，根據(jù)用藥的差別分為對照組（44例）和治療組（44例）。對照組患者靜脈滴注醋酸奧曲肽注射液，0.1 mg加入生理鹽水250 mL，1次/d；治療組在對照組的基礎(chǔ)上口服裸花紫珠顆粒，3 g/次，4次/d。兩組患者均經(jīng)4 d治療。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者門靜脈血流、脾靜脈血流、門靜脈內(nèi)徑、脾靜脈內(nèi)徑、止血時(shí)間、輸血量、肝靜脈游離壓（FHVP）、肝靜脈鍥入壓（WHVP），及血清超敏C反應(yīng)蛋白（hs-CRP）、血管緊張素Ⅱ（AT-II）、腎素活性（PRA）、抗利尿激素（ADL）和一氧化氮（NO）水平。結(jié)果 治療后，對照組和治療組臨床有效率分別為81.82%和97.73%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。經(jīng)治療，兩組門靜脈血流、脾靜脈血流、門靜脈內(nèi)徑及脾靜脈內(nèi)徑均明顯減?。?i>P<0.05），且治療組明顯小于對照組（P<0.05）。經(jīng)治療，治療組患者止血時(shí)間明顯短于對照組（P<0.05），且輸血量明顯小于對照組（P<0.05）。經(jīng)治療，兩組患者FHVP、WHVP均明顯降低（P<0.05），且治療組患者降低更顯著（P<0.05）。經(jīng)治療，兩組患者血清hs-CRP、AT-II、NO、PRA、ADL水平均明顯降低（P<0.05），且治療組明顯低于對照組（P<0.05）。結(jié)論 裸花紫珠顆粒聯(lián)合奧曲肽治療肝硬化上消化道出血療效好，可改善機(jī)體血流動力學(xué)指標(biāo)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Luohua Zizhu Granules combined with octreotide in treatment of upper gastrointestinal hemorrhage due to cirrhosis. Methods Patients (88 cases) with upper gastrointestinal hemorrhage due to cirrhosis in Qionghai People's Hospital from March 2018 to March 2019 were divided into control (44 cases) and treatment (44 cases) groups based on different treatments. Patients in the control group were iv administered with Octreotide Acetate Injection, 0.1 mg added into normal saline 250 mL, once daily. Patients in the treatment group were po administered with Luohua Zizhu Granules on the basis of the control group, 3 g/time, four times daily. Patients in two groups were treated for 4 d. After treatment, the clinical efficacy was evaluated, and the blood flow velocity of portal vein and splenic vein, diameter of portal vein and splenic vein, hemostasis time and blood transfusion volume, FHVP, WHV, and the serum level of hs-CRP, AT-II, NO, PRA, and ADL in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 81.82% and 97.73% respectively, and there were differences between two groups (P<0.05). After treatment, the blood flow velocity of portal vein and splenic vein, diameter of portal vein, and splenic vein in two groups were significantly decreased (P<0.05), and these hemodynamic parameters in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the hemostasis time in the treatment group was significantly shorter than that in the control group (P<0.05), and the blood transfusion volume was significantly less than that in the control group (P<0.05). After treatment, the FHVP and WHVP in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the serum level of hs-CRP, AT-II, NO, PRA, and ADL in two groups were significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion Luohua Zizhu Granules combined with octreotide in treatment of upper gastrointestinal hemorrhage due to cirrhosis has good clinical effect, can improve hemodynamic parameters, and has a certain clinical application value.

R977