Tagamet for the prevention of sub-acute severe hepatitis and stomach bleeding: observed effects. The original solid. Tagamet for severe hepatitis B patients, by the satisfaction of the observed effect over four years, are reported below. Materials and methods: cases were selected from 1989 to 1992 among hospital patients with sub-acute severe hepatitis. Etiology genotyping was already typed, and its diagnosis and typing were according to the standards established by the Sixth National Conference on Hepatitis in 1990. Hospitalized patients had gastrointestinal bleeding (hematemesis, vomiting coffee-like substances, or passing tarry stools) and were under observation without unconscious medication. Over four years, 42 cases were treated and observed. The treatment group consisted of individuals aged 29 to 60 years old, including 33 males and 9 females. The main symptoms included anorexia in 37 cases, nausea or vomiting in 28 cases, inversion lethargy in 22 cases, obvious weakness in 23 cases, personality disorders or excitement in 19 cases, reduced thinking and computing power in 18 cases, day-night inverted sleep and chatter in 10 cases, and epistaxis in 4 cases. The main signs included obvious or deep jaundice in 42 cases, abdominal bloating in 21 cases (drum Asr), ascites in 19 cases, flapping tremor in 18 cases (percussion, liver dullness, narrowed liver volume as shown by B-ultrasound) in 13 cases, mental confusion in 12 cases, and subcutaneous hemorrhage at injection or static points in 8 cases. Laboratory results showed serum bilirubin ranging from 179 to 427.65 μmol/L, with a mean of 251.44 ± 69.12 μmol/L. Serum pyruvic transaminase (ALT, normal 30 U/L) ranged from 21 to 265 U/L, with a mean of 43.69 ± 33.12 U/L (with SB Hee enzyme gall separation). Prothrombin activity (PTA, normal 75 to 100) ranged from 59.19 to 35.67, with a mean of 42.38 ± 9.55%.
Secondly, the treatment group was given Tagamet tablets (produced by Tianjin, China and the United States SmithKline) at 400 mg per dose, twice daily, for a treatment period of 20 days. No other acid-fast agents or gastric mucosal protective agents were used during this treatment. Thirdly, the observation method was based on a control group from 1988 that included subacute severe hepatitis patients who were treated with Tagamet, sweetened guanidine H |-blockers as controls. Both groups received basically the same basic treatment, symptomatic treatment, and supportive care. After treatment, the occurrence of stomach bleeding and mortality is shown in the attached table.
Discussion: Upper gastrointestinal bleeding is a serious complication of severe hepatitis, and Gu reported that among 56 cases of severe hepatitis, upper gastrointestinal bleeding (mainly stomach bleeding) accounted for 57%. This ranks as the first complication of severe hepatitis. Stomach bleeding can lead to hemorrhagic shock, bowel ischemia and hypoxia-induced hepatorenal syndrome, and can further increase nitrogen poisoning, inducing or exacerbating hepatic coma. Therefore, upper gastrointestinal bleeding can be a direct cause of death. The reasons for stomach bleeding in severe hepatitis are complex. Necrotic liver cell components are absorbed into the bloodstream, becoming a health solidification sub-trigger for DIC. Due to the consumption of clotting factors and fibrinolysis in DIC, the function of prothrombin synthesis by hepatocytes and multiple coagulation loops declines. Increased vascular permeability in the stomach wall leads to widespread gastric erosion and bleeding under acidic conditions. Prevention and control of stomach bleeding in the treatment of severe hepatitis B is one of the most important focuses, requiring comprehensive measures. However, these measures often fall short of satisfaction. In this paper, the incidence of digestive tract bleeding between 1988 and the first four years was analyzed. After the application of Tagamet starting in 1989, such complications were reduced to 33.3% (P < 0.01) over the next four years. This proves that Tagamet plays a significant role in preventing gastric bleeding. Its main mechanism (Tagamet, also known as cimetidine) is as an Ht receptor blocker, with a molecular structure similar to histamine Ht receptors, competitively inhibiting them. It suppresses the stimulation of gastric acid secretion by histamine or pentagastrin, significantly inhibiting basal acid secretion and nighttime gastric acid secretion under various stimuli. Therefore, Tagamet eliminates the corrosive effects of acid on the gastric mucosa, prevents the appearance of gastric mucosal damage, and prevents oozing and bleeding of blood vessels in the stomach wall, thus preventing the occurrence of stomach bleeding. Resistance table subacute severe hepatitis 42 cases: the effect of Tagamet in preventing stomach bleeding. △ refers to single vomiting or coffee-like street vomiting, more than 50 ml. - Does not include simultaneous or prior vomiting or coffee-like substance vomiting by Lao Zhao.