中西药联用防治500例血友病出血的临床研究

Clinical Study of Combination of Chinese Medicine and Western Medicine in Treatment of 500 Patients with Hemophilia Hemorrhage

LIU Shan-xi,LIU Yi-guo,LI Fei,et al

Department of Hemophilia,Shaanxi Yida Hematology Institute Xi'an 710061(https://www.daowen.com)

ABSTRACT Objective To study the effect and safety of haemostatic apozem combined with haemostatic mixture on hemophilia hemorrhage.Methods Five hundred hemophilia patients were randomly recruited from Shaanxi Yida hematology Institute from February 2005 to July 2010.Under the condition of using blood products such as platelet cofactorsⅧ and Ⅸ, oral admi nistration of haemostatic apozem combined with intravenous dripping of haemostatic mixture were given to 332 hemorrhagic patients and 451 patients in need of surgery for hemorrhage prev ention.The treament was lasted for three successive weeks.The hemostatic time, hemorrhage absorption(recovery)time,and their safety were observed.Results The hemostatic time for open bleeding and closed bleeding was(0.85±0.83)h and(2.69±0.65)h respectively.The average hemostatic time was(2.00±0.69)h.The recovery time for different portions was as follows respectively; intracranial hemorrhage(14.13±6.01)days;muscular hemorrhage(18.18±7.34)days;hematuria(8.2 5±4.69)days;arthrorrhage(3.27±1.31)days,ecchymoma(7.16±2.32)days;bleeding of oral and nasal cavltles(4.26±1.35)days;intramedullary hemorrhage(19.15±1.36)days;hematoma ulceration(50.0 1±20.91)days.The hemorrhage recovery ratio was 99.10%(329/332).The success rate of preventing from surgery hemorrhage was 100%(451/451).No severe adwerse reaction occurred during the therapeutic course.Conclusions Haemostatic apozem combined with haemostatic mixture was effe-cttive and fast in preventing and hemophilia hemorrhage,with no complications or adverse reactions.It could be taken as the first choice for prevention and treatment of hemophilia hemorrhage.

KEYWORDS Hemophilia; hemorrhage; hemostatic apozem; hemostatic mixture;safety

出血是血友病(hemophilia,H)的主要症状和患者致残、致死的主要原因。自1940年美国哈佛大学Cohn教授发明低温乙醇法提取凝血因子治疗血友病出血以来,大大改善了血友病出血状况,但随之而来的是病毒感染和同种异体特异性凝血因子抗体(抑制物)的产生,抑制、灭活患者自身凝血因子活性,加重出血尤其是抑制物的产生,凝血因子的应用越来越受到全世界医疗界的关注「1-5」。2004年世界卫生组织(WHO)提出拟废除人凝血因子Ⅷ(FⅧ)、Ⅸ(FⅨ)浓缩剂的应用,因此,研究防治血友病出血的新药势在必行。我院按照止血中西药互补原理,开展了中药止血煎剂联合西药止血合剂防治血友病出血的前瞻性研究,取得了良好的止血效果和安全性,现报道如下。