| The peptic ulcer hemorrhage is a clinical common disease andfrequently-occurring disease, simultaneously also is a internal medicine departmentacute disease. In the UGH disease incidence rate adult probably is 1/1000 (every year),accounts for 2.43％which the internal medicine department in-patient counts, itsmortality rate is approximately 8％-14％, gastric ulcer and other digestive the ulcerscause the upper gastrointestinal hemorrhage occupies 40％-50％, if has not been ablethe prompt effective treatment, it will be able to cause some serious body-wide harm,for example: the hemorrhagic shock, ischemical reperfusion injury, each kind ofinternal organs function failure, even died. Therefore searching for each effectivehematischesis method, the hematischesis medicine is the urgent need which saves thepeptic ulcer hemorrhage patients.There is many commonly used hemorrhage on clinical at present, for instance:vitamin K, thromboplastin, Aglumin etc. which through influencing some bloodcoagulation factor, promote or resume blood coagulation course to stops blooding;6-Aminoacetic Acid and Aminomethylbenzoic Acid, etc. which through inhibiting thefibrinolytic system to stops blooding; Carbazochrome which through reducing thecapillary penetratingly to stops blooding. But the classical styptic medicine haveshortcoming including being easy to initiate high state of congealing while poorfunction specific that can't ignore, water-solubility is used badly and clinicallylimitedly, the medicine route is single and inconvenient to use that give. It has a longhistory that traditional Chinese medicine arrests blood,《Treatise on Febrile Diseases》written by zhang zhongjing Hart Dynasty is the earliest literature that records rhubarbcan be used to stop blooding and apply clinically to various blood cards, so known ascard key medicine of blood. Single d- catechu Amoxcillinand Gallic acid which is effective styptic composition of rhubarb, offer material basis for explaining the stypticfunction of rhubarb. According to the principle of the traditional Chinese medicine"Bum the charcoal keep nature", we adopt the way that combining modern Hi-Techwith tradition technology together to develop new traditional Chinese medicine:micron rhubarb charcoal, enable it improve absorption of the medicine and biologyavailability maximumly on the basis of keeping original nature, shortened the gettingup for time of result of the medicine at the same time. This subject plans to exploreomni-directional styptic function and mechanism of micron rhubarb charcoal throughclinical observation and experiment study, establish the pharmacology foundation fordeveloping new traditional Chinese medicine preparation.1 Clinical observation on the endoscopic treatment of hemorrhage of pepticulcer spraying micron rhubarb charcoalObjective: To observe the endoscopic treatment of peptic ulcer hemorrhage sprayingmicron rhubarb charcoal.Methods: 90 cases of peptic ulcer hemorrhage patients were randomly divided intomicron rhubarb charcoal group (treatment group) and norepinephrine (control group),each having 45 cases. Using gastroscope spraying method to observe the average timeand the success rate of hemostasis; the number of melena and hematemesis,hemoglobin and hemostasis efficient after endoscopic treatment between two groups.Results: Endoscopic hemostatic therapy group compared with the control groupaverage hemostasis time is significantly reduced (P＜0.01) and significantly highersuccess rate hemostatic (P＜0.01), reaching anaverage of 96％;After treatment in thetherapy group the average number of melena and hematemesis is significantly lessthan the control group (P＜0.05); and the two groups compare to the averagehemoglobin was no statistically significant difference (P＞0.05); Hemostatic efficacy of the treatment group were higher than control group (P＜0.01), no significantadverse reactions, is safe.Conclusion: Endoscopic sprinkler micron rhubarb charcoal is a safe and effectivetreatment for patients of peptic ulcer hemorrhage, be worthy to clinical applicationand promotion.2 Experiment study on Micron rhubarb making domestic rabbit's gastric tissuehemostasis locallyObjective: To observe local hemostatic effects of micron rhubarb charcoal tax ondomestic rabbit gastric bleeding in order to determine the validity of animalexperiments.Methods: The rabbits were studied by four Group 4 x 4 Latin square design. Recordsthe bleeding time of rabbit whose gastric tissue local bleeding after spraying microncarbon rhubarb, Yunnan Baiyao, Norepinephrine and Physiological saline.Results: Each drug group could shorten the average time of stomach blooding,compared with the Physiological saline group, there was a significant difference (P＜0.01) Compared with the Yunnan Baiyao NA superior to Yunnan Baiyao (P＜0.05),and micron rhubarb charcoal has the most obvious effect (P＜0.01); the difference ofbleeding time between the drug groups and Physiological saline group weresignificantly (P＜0.01); compared with the Yunnan B aiyao, micron rhubarb charcoalis the better one(P＜0.05).Conclusion: micron rhubarb charcoal have obvious effect in treating stomach localbleeding of rabbit, hemostatic effect is better than Yunnan Baiyao and norepinephrine.3 Effects of micron rhubarb charcoal on the hemostatic mechanism in rat Objective: Through observing the influence of micron rhubarb charcoal on theblooding and hemoglutination time, the blood coagulation system, fibrinolysis systemand faction of platelet to discuss its function and mechanism of stops bleeding, forproviding the theory basis with the medicine clinical, lays the Pharmacologyfoundation for the development new Chinese native medicine preparation.Methods: SD rats were divided into contral gruop,Yunan Baiyao group and micronrhubarb charcoal high,normal and low dosage gruop, ig six days. We studied theeffects of micron rhubarb charcoal on the coagulation time(CT), bleeding time (BT),the prothrombin time(PT) and the active partial thromboplastin time (APTT), tissueplasmiongen activity (t-PA)and Plasm inogen activator inhibiter (PAI-1), plateletaggregation induced by ADP were also tested.Results: (1) The micron rhubarb charcoal high,normal and low dosage gruop andYunan Baiyao group could obviously reduce the BT, CT, the difference is prominentcompared with control group(P＜0.01). Compared with Yunan Baiyao group, functionof micron rhubarb charcoal high dosage gruop is obvious (P＜0.05)(2) The micronrhubarb charcoal high,normal and low dosage gruop and Yunan Baiyao group couldobviously reduce the PT and APTT (P＜0.01); compared with Yunan Baiyao group, themicron rhubarb charcoal high,normal dosage gruop less than Yunan Baiyao group onPT (P＜0.05). (3) Yunan Baiyao group can reduce activity of t-PA (P＜0.05);andadvance the activity of PAI-1 (P＜0.05); Every group of micron rhubarb charcoal hasnot influenced the change of t-PA and PAI-1 content. (4) Medicine each group canobviously enhance the nature of platelet aggregation inducted by ADP (P＜0.05),inwhich the function of the micron rhubarb charcoal high,normal dosage group areobvious (P＜0.01); compared with Yunan Baiyao group, there is a statistics meaningthat micron rhubarb charcoal high dosage gruop enhance the nature of plateletaggregation inducted by ADP(P＜0.05). Conclusion: The main hemostasia mechanism of micron rhubarb charcoal was to produce prothrombin and thrombin by activatingboth endogenous and exogenous blood coagulation factor in the course of bloodcoagulation. And increase the gathering of the blood platelet at the same time, havenothing to do with the fibrinolysis activity.In brief, this research indicated that the endoscopic treatment of hemorrhage ofpeptic ulcer spraying micron rhubarb charcoal be able to play the role in hemostaticeffectively, and the experimental study also confirmed this result. Experimental studyof its mechanism verifies that micron rhubarb charcoal can remarkably reduce theblooding and hemoglutination time, PT and APTT, enhances platelet aggregationsimultaneously, but has not affected activeness of t-PA and PAI-1. Therefore, it ispossibly the vital mechanism that producing prothrombin and thrombin by activatingboth endogenous and exogenous blood coagulation factor in the course of bloodcoagulation, and increases platelet aggregation in course of the micron rhubarbcharcoal stopping bleeding. |
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