目的 探讨健胃愈疡颗粒联合西咪替丁治疗重症患者应激性溃疡的临床疗效。方法 选择2019年6月—2022年5月上海市杨浦区中心医院收治的103例应激性溃疡患者，随机分为对照组（51例）和治疗组（52例）。对照组静脉滴注西咪替丁注射液，0.2 g加入250 mL生理盐水中，2次/d。治疗组在对照组基础上口服健胃愈疡颗粒，9 g/次，3次/d。观察两组患者临床疗效，比较治疗前后两组患者临床症状评分，血清C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、胃泌素（MTL）、缺血修饰白蛋白（IMA）、超氧化物歧化酶（SOD）和丙二醛（MDA）水平及不良反应。结果 治疗后，治疗组临床有效率明显高于对照组（96.15% vs 84.31%，P＜0.05）。治疗后，治疗组临床症状评分均明显比对照组低（P＜0.05）。治疗后，两组血清CRP、TNF-α、MTL、IMA和MDA水平均明显降低，而血清SOD水平明显升高（P＜0.05），且治疗组血清指标水平均明显好于对照组（P＜0.05）。治疗期间，治疗组患者不良反应发生率为3.85%，对照组为17.65%，两组比较差异有统计学意义（P＜0.05）。结论 健胃愈疡颗粒联合西咪替丁治疗重症患者应激性溃疡的临床疗效比单纯应用西咪替丁好，有助于临床症状的减轻，改善炎性因子水平，且安全性较好。

Objective To investigate the clinical efficacy of Jianwei Yuyang Granules combined with cimetidine in treatment of stress ulcer. Methods Patients (103 cases) with stress ulcer in Shanghai Yangpu District Central Hospital from June 2019 to May 2022 were randomly divided into control (51 cases) and treatment (52 cases) group. 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 Jianwei Yuyang Granules on the basis of the control group, 9 g/time, three times daily. After treatment, the clinical evaluation was evaluated, and the clinical symptom scores, the levels of serum CRP, TNF-α, MTL, IMA, SOD and MDA in two groups before and after treatment were compared, as well as adverse reactions. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (96.15% vs 84.31%, P< 0.05). After treatment, the clinical symptom scores of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the levels of serum CRP, TNF-α, MTL, IMA and MDA were significantly decreased, while the level of serum SOD was significantly increased in two groups (P < 0.05), and the levels of serum indexes in the treatment group were significantly better than those in the control group (P < 0.05). During the treatment, the incidence of adverse reactions was 3.85% in the treatment group and 17.65% in the control group, there was significant difference between the two groups (P < 0.05). Conclusion The clinical efficacy of Jianwei Yuyang Granules combined with cimetidine in treatment of stress ulcer in severe patients is better than that of cimetidine alone, which is helpful to alleviate clinical symptoms, improve the level of inflammatory factors, and is safe.

R975

上海市杨浦区卫生和计划生育委员会科研课题(YP18M24)