Clinical observation of oral Yunnan Baiyao and thrombin combined with proton pump inhibitors for treatment of upper gastrointestinal hemorrhage after percutaneous coronary intervention

AIM:To evaluate the clinical effect and safety of oral Yunnan Baiyao and thrombin combined with proton pump inhibitors (PPI) for the treatment of upper gastrointestinal hemorrhage induced by combined application of clopidogrel and aspirin in patients undergoing percutaneous coronary intervention (PCI). METHODS: A total of 77 patients with post-PCI upper gastrointestinal hemorrhage and medication of clopidogrel and aspirin were randomly divided into treatment group (39 cases) and control group (38 cases). In the treatment group, Yunnan Baiyao (1.0 g) plus thrombin (1 000 U) was dissolved in 4℃ normal saline (100 ml) and was orally administered once every 6 h, whereas in the control group norepinephrine (8.0 mg) was dissolved in 4℃ normal saline (100 ml) and orally administered once every 6 h. PPI, necessary fluid replacement and blood transfusion were given in both groups and the rates of hemorrhage cessation at 72 h and occult blood in stool at 120 h and 168 h were observed. RESULTS: The rates of hemorrhage cessation in the treatment group were obviously higher than in the control group (92% vs. 74%, P<0.05), and the amount of blood transfusion was obviously lower than in the control group at 72 h ［(1.5±0.3) U vs. (1.8±0.5) U, P<0.01］. The rates of cessation of occult blood in stool in the treatment group were obviously higher than in the control group at 120 h and 168 h (95% vs. 76%, P<0.05; 90% vs. 71%, P<0.05) and no event of in-stent thrombosis occurred. CONCLUSION: Oral Yunnan Baiyao and thrombin are effective and safe in the treatment of upper gastrointestinal hemorrhage induced by combined application of clopidogrel and aspirin in patients undergoing PCI.