【摘要】 目的　分析青黛引起消化道出血的临床特点 ,讨论可能的致病机制。方法　对 6例内服含青黛成分的中药后发生消化道出血病人的病史、临床表现、实验室检查、内镜特点及病理表现进行总结分析 ,结合文献报道分析其可能的致病机制。结果　患者均在服药 1个月内发病 ,首发症状为下腹痛 ,随之出现血便 ,早期可有血白细胞升高。病变范围较为广泛 ,常见直肠受累。内镜下可表现为黏膜充血、水肿 ,点片状糜烂 ,纵形或不规则形溃疡。病理显示有黏膜萎缩、退行性变和小血管内纤维素性血栓形成。患者在停药、予丹参或罂粟碱等治疗后症状很快消失 ,肠道损伤恢复。继续服用同类药物可引起复发。结论　含青黛成分中药可引起消化道出血 ,临床表现与缺血性结肠炎相似。此类药物的肠道不良反应引起重视更多还原

【Abstract】 Objective To analyze the clinical feature and pathogenesis of the traditional Chinese medicine natural indigo(QingDai)induced hematochezia.Methods Clinical data,including illness history,clinical manifestation,labaortory tests,endoscopy,and histological results of the six patients who had hematochezia after taking the traditional Chinese medicine with natural indigo were analyzed. Results Onset of symptoms took place within one month after the medication administration.The inital symptom was lower abdominal pain.Hemorrhage followed in several hours to several days accompanied the white blood cell count elevated in the earlier period of hematochezia.The range of the colon lesions was widespreaded,and the rectum was usually involved.Endoscopy showed that mucosal hyperemia,edema,erosion,and strip or irregular shape ulcer.Atrophy,degeneration,and cellulose thrombosis in small vessels were main manifests histologic examination.The patients’symptoms relieved soon after withdrawal the Qingdai and treating with Danshen or Papaverine,but symptom mentioned above relapsed when the patients took the same kind of medicine.Conclusion The clinical features of hematochezia after taking the traditional Chinese medicine with natural indigo were coincident with ischemic colitis’s.更多还原