目的 探讨瑞巴派特联合铝镁加混悬液治疗应激性胃溃疡的临床疗效。方法 选取2022年3月—2023年3月钦州市第二人民医院收治的96例重症应激性胃溃疡患者，按照随机数字表法将所有患者分为对照组和治疗组，每组各48例。对照组餐后1 h口服铝镁加混悬液，1袋/次，3次/d。治疗组在对照组的基础上口服瑞巴派特片，1片/次，3次/d。两组连续用药7 d。观察和比较两组的临床疗效和临床症状缓解时间，比较两组治疗前后胃肠功能指标（胃动素、胃泌素、胃液pH值）、血管内皮素-1（ET-1）、白细胞介素-6（IL-6）、血清降钙素（PCT）、肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，治疗组总有效率是97.92%，显著高于对照组的81.25%（P＜0.05）。治疗后，治疗组腹痛、腹胀、烧灼痛、反酸等症状缓解时间均显著短于对照组（P＜0.05）。治疗后，两组胃动素、胃液pH值较治疗前显著升高，而胃泌素显著降低（P＜0.05）；治疗后，治疗组胃肠功能指标改善优于对照组（P＜0.05）。治疗后，两组患者ET-1、IL-6、TNF-α、PCT水平均较同组治疗前显著降低（P＜0.05）；治疗后，治疗组ET-1、IL-6、TNF-α、PCT水平低于对照组（P＜0.05）。结论 瑞巴派特联合铝镁加治疗应激性溃疡效果确切，可修复损伤黏膜，有效增强胃肠功能，可抑制炎症反应及调节炎性因子释放，值得临床借鉴。

Objective To observe the clinical efficacy of rebamipide combined with almagate in treatment of stress gastric ulcer. Methods Ninety-six patients with severe stress gastric ulcer admitted to the Second People’s Hospital of Qinzhou from March 2022 to March 2023 were selected and divided into control group and treatment group according to random number table method, with 48 patients in each group. Patients in the control group were po administered with Almagate Suspension 1 h after meal, 1 bag/time, three times daily. Patients in the treatment group were po administered with Rebamipide Tablets on the basis of the control group, 1 tablet/time, three times daily. Patients in two groups were treated for 7 d. The clinical efficacy and symptom remission time of the two groups were observed and compared, and the levels of gastrointestinal function indexes (motilin, gastrin, pH of gastric juice), endothelin-1 (ET-1), interleukin-6 (IL-6), serum calcitonin (PCT) and tumor necrosis factor-α (TNF-α) before and after treatment were compared between two groups. Result After treatment, the total effective rate of the treatment group was 97.92%, which was significantly higher than that of the control group (81.25%, P < 0.05). After treatment, the remission time of abdominal pain, abdominal distension, burning pain and acid reflux in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the pH values of motilin and gastric juice in two groups were significantly increased, but gastrin were significantly decreased (P < 0.05). After treatment, gastrointestinal function indexes in the treatment group were better than those in the control group (P < 0.05). After treatment, the levels of ET-1, IL-6, TNF-α and PCT in two groups were significantly decreased compared with those before treatment (P < 0.05). After treatment, the levels of ET-1, IL-6, TNF-α and PCT in the treatment group were lower than those in control group (P < 0.05). Conclusion Rebamipide combined with almagate has a definite effect in treatment of stress gastric ulcer, and can repair damaged mucosa, effectively enhance gastrointestinal function, and also can inhibit inflammatory response and regulate the release of inflammatory factors, which is worthy of clinical reference.

R975

钦州市科学研究与技术开发计划项目（20199504）