Tuesday, 26 November 2013

Upper gastrointestinal bleeding – Treatments In Traditional Chinese medicine perspective

The prevalence of upper gastrointestinal (GI) diseases is increasing in subjects aged 65 years and over. Pathophysiological changes in esophageal functions that occur with aging may, at least in part, be responsible for the high prevalence of
1. Gastro-esophageal reflux disease (GERD) in old age.
2. The incidence of gastric and duodenal ulcers and their bleeding complications is increasing in old-aged populations worldwide.
3.  H. pylori infection in elderly patients with H. pylori-associated peptic ulcer disease and severe chronic gastritis
4.  Almost 40% of GU and 25% of DU in the elderly patients are associated with the use of NSAID(1) and/or aspirin(2).(a)
IV. Upper gastrointestinal bleeding
Upper gastrointestinal bleeding (UGIB) is defined as hemorrhaging derived from a source proximal to the ligament of Treitz. It is life threatening and considered as medical emergency, which is followed by high mortality rate, ranging from 6 to 15% in spite of modern diagnostic methods and treatment.

Treatments In traditional Chinese medicine perspective
a. Wen She decoction (WSD)
 Wen She decoction (WSD), a Chinese herbal formula, consists of Codonopsis pilosulae, Atractylodes macrocephala, Poria cocos, Glycyrrhiza uralensis, Zingiber officinale, Os sepiae Halloysitum rubrum and Astragalus membranaceus. In a clinical study to investigate the effects of  Wen She decoction (WSD)ion treatment of acute upper digestive tract hemorrhage, found that the effective rate of WSD of the stool OB (+) becoming (-) within 5 days was more than 95%. . It is effective in stopping bleeding by warming the Spleen and tonifying Qi(24)

b. Rheum officinale Baill, Rheum palmatum L, and Rheum tanguticum Maxim ex Balf
Evidences incated that Rheum officinale Baill, Rheum palmatum L, and Rheum tanguticum Maxim ex Balf have an efective rate of 90.7%, 93.7%, and 92.8% respectively in treating upper digestive tract bleeding, according to the 10 years study by Shanghai Xiang Shan TCM Hospital(25).

c. Etc.

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(24) http://www.ncbi.nlm.nih.gov/pubmed/2766422
(25) http://www.ncbi.nlm.nih.gov/pubmed/2379297 


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