目的 探討復(fù)方大紅袍止血膠囊聯(lián)合維生素K₁治療膽道術(shù)后出血的治療效果。方法 選擇2013年6月—2019年8月來重慶市石柱縣中醫(yī)院治療的80例膽道術(shù)后出血患者作為研究對象，按照治療方法將患者分為對照組（n=40）和觀察組（n=40）。對照組患者給予維生素K₁注射液治療，10 mg/次，2次/d。觀察組患者在對照組治療的基礎(chǔ)上外加復(fù)方大紅袍止血膠囊，4粒/次，3次/d。比較兩組患者的24 h內(nèi)止血率、輸血量、止血時間及住院時間。分析兩組患者治療前后的血清標(biāo)志物以及肝功能變化。隨訪3個月，觀察兩組患者預(yù)后再出血發(fā)生率。結(jié)果 治療后，觀察組24 h內(nèi)止血率高于對照組，輸血量、止血時間、住院時間均顯著低于對照組（P<0.05）。治療后，兩組患者的血清甘膽酸（CG）、人層黏連蛋白（LN）、Ⅲ型前膠原（PCⅢ）水平顯著降低（P<0.05），且觀察組血清CG、LN和PCⅢ水平降低更明顯（P<0.05）。治療后，兩組Child-Pugh改良評分均顯著降低（P<0.05）；且觀察組明顯低于對照組（P<0.05）。術(shù)后隨訪3個月，觀察組患者的再出血發(fā)生率明顯低于對照組（P<0.05）。結(jié)論 復(fù)方大紅袍止血膠囊聯(lián)合維生素K1可以較好的控制患者膽道術(shù)后出血，改善肝功能，降低再次出血的發(fā)生率，效果較好，具有一定的臨床應(yīng)用價值。

Objective To investigate the therapeutic effect of Compound Dahongpao Zhixue Capsules combined with vitamin K₁ in treatment of postoperative biliary hemorrhage. Methods Eighty patients with postoperative biliary tract hemorrhage treated in Shizhu County Hospital of Traditional Chinese Medicine from June 2013 to August 2019 were selected as the research subjects, and the patients were divided into control group (n=40) and observation group (n=40) according to the treatment methods. Patients in the control group were given Vitamin K₁ Injection, 10 mg/time, twice daily. Patients in the observation group was additively treated with Compound Dahongpao Zhixue Capsules, 4 capsules/time, three times daily. The hemostasis rate within 24 h, blood transfusion volume, hemostasis time and hospitalization time of two groups were compared. Serum markers and liver function changes before and after treatment were analyzed in two groups. Follow-up for 3 months was conducted to observe the difference in the rate of prognostic rebleeding between the two groups. Results After treatment, the hemostasis rate in observation group within 24 h was higher than that in control group, and the amount of blood transfusion, hemostasis time and hospitalization time were significantly lower than those in control group (P < 0.05). After treatment, the serum levels of CG, LN, and PC Ⅲ were significantly reduced in two groups (P < 0.05), and the observation group reduce the level of serum CG, LN, and PC Ⅲ were more obvious (P < 0.05). After treatment, Child-Pugh improved scores in two groups were significantly decreased (P < 0.05), and the observation group was significantly lower than the control group (P < 0.05). The incidence of rebleeding in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion Compound Dahongpao Zhixue Capsules combined with vitamin K1 can better control postoperative biliary bleeding, improve liver function, reduce the incidence of rebleeding, the effect is good, has a certain value of clinical application.

R982

重慶市科技計劃項目（CSTC2018JSCX-MSYBX0279）