目的 探討蒲元和胃膠囊聯(lián)合西咪替丁治療重癥患者應(yīng)激性潰瘍的臨床療效。方法 選擇2019年8月-2021年8月在濮陽(yáng)市中醫(yī)醫(yī)院診療的80例重癥患者應(yīng)激性潰瘍患者,隨機(jī)分為對(duì)照組和治療組,每組各40例。對(duì)照組患者靜脈滴注西咪替丁注射液,0.2g加入生理鹽水250mL,2次/d。在對(duì)照組的基礎(chǔ)上,治療組口服蒲元和胃膠囊,4粒/次,3次/d。兩組患者治療7周。觀察兩組患者臨床療效,比較治療前后兩組患者癥狀緩解時(shí)間,丙二醛(MDA)、超氧化物歧化酶(SOD)、缺血修飾白蛋白(IMA)水平,及血清胃泌素(MTL)、白細(xì)胞介素6(IL-6)、腫瘤壞死因子α(TNF-α)、C反應(yīng)蛋白(CRP)水平。結(jié)果 治療后,治療組患者總有效率為97.50%,明顯高于對(duì)照組的82.50%(P<0.05)。治療后,治療組嘔血、柏油樣便、腹痛、肌緊張緩解時(shí)間均明顯短于對(duì)照組(P<0.05)。治療后,兩組MDA、IMA水平明顯降低,SOD水平明顯升高(P<0.05),且治療組MDA、IMA和SOD水平明顯好于對(duì)照組(P<0.05)。治療后,兩組MTL、IL-6、TNF-α、CRP水平明顯下降(P<0.05),且治療組明顯低于對(duì)照組(P<0.05)。治療期間,治療組不良反應(yīng)發(fā)生率明顯低于對(duì)照組(7.49% vs 17.50%,P<0.05)。結(jié)論 蒲元和胃膠囊聯(lián)合西咪替丁治療療效明顯,能更好地改善癥狀,降低炎性反應(yīng),加快應(yīng)激性潰瘍面愈合。

Objective To investigate the clinical effect of Puyuanhewei Capsules combined with cimetidine in treatment of stress ulcer in severe patients. Methods Patients (80 cases) with stress ulcer in Chinese Medicine Hospital of Puyang from August 2019 to August 2021 were randomly divided into control and treatment group, and each group had 40 cases. Patients in the control group were iv administered with Cimetidine Injection, 0.2 g added into normal saline 250 mL, twice daily. Patients in the treatment group were po administered with Puyuan Hewei Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 7 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, the levels of MDA, SOD, IMA, MTL, IL-6, TNF-α, and CRP in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 97.50%, which was significantly higher than 82.5%of the control group (P < 0.05). After treatment, the relief time of hematemesis, tar-like stools, abdominal pain and muscle tension in treatment group was significantly shorter than that in control group (P < 0.05).. After treatment, the levels of MDA and IMA in two groups were significantly decreased, while the level of SOD was significantly increased (P < 0.05), and the levels of MDA, IMA, and SOD in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the levels of MTL, IL-6, TNF-α, and CRP in two groups were significantly decreased, and which in the treatment group were significantly lower than that in the control group (P < 0.05). During the treatment, the adverse reaction rate in the treatment group was significantly lower than that in the control group (7.49% vs 17.50%, P < 0.05). Conclusion The curative effect of Puyuan Hewei Capsules combined with cimetidine in treatment of stress ulcer in severe patients is obvious, which can improve the symptoms, reduce the inflammatory reaction and speed up the healing of stress ulcer.

R975

河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題（20170147）