目的 探讨胃康胶囊联合蛇毒血凝酶注射液治疗上消化道出血的临床疗效。方法 回顾性分析2020年3月—2021年3月在南阳市第二人民医院治疗的114例上消化道出血患者临床资料，根据用药的差别分为对照组和治疗组，每组各57例。对照组患者给予蛇毒血凝酶注射液，立即静注0.5 U，同时肌肉注射1 U，此后每隔6 h肌注1 U；治疗组在对照组基础上口服胃康胶囊，1.2 g/次，3次/d。两组患者均治疗7 d。观察两组患者临床疗效，比较治疗前后两组凝血指标，血清前列腺素E₂（PGE₂）、白细胞介素-17（IL-17）、肾素活性（PRA）、6-酮前列腺素F1α（6-Keto-PGF1α）和醛固酮（ALD）水平及止血时间和潜血转阴时间。结果 经治疗，对照组和治疗组总有效率分别为84.21%和98.25%（P<0.05）。经治疗，两组血清凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）均降低，而纤维蛋白原（FIB）均升高（P<0.05），且治疗组凝血指标改善更明显（P<0.05）。经治疗，两组患者血清PGE2水平明显升高，而IL-17、PRA、6-Keto-PGF1α、ALD水平明显降低（P<0.05），且治疗组血清学指标水平明显好于对照组（P<0.05）。经治疗，治疗组在止血时间和潜血转阴时间上均早于对照组（P<0.05）。结论 胃康胶囊联合蛇毒血凝酶注射液治疗上消化道出血效果明显，不仅可改善机体凝血功能，还可促进血清PGE2、IL-17、PRA、6-Keto-PGF1α、ALD水平改善。

Objective To investigate the clinical effect of Weikang Capsules combined with Hemocoagulase Injection in treatment of upper gastrointestinal bleeding. Methods The clinical data of 114 patients with upper gastrointestinal bleeding treated in Nanyang Second People's Hospital from March 2020 to March 2021 were analyzed retrospectively and divided into control and treatment groups according to the difference of medication, and each group had 57 cases. Patients in the control group were administered with Hemocoagulase Injection, immediate intravenously dripped of 0.5 unit, meanwhile, 1 unit was injected intramuscularly, after that, 1 unit was injected intramuscularly every 6 hours. Patients in the treatment group were po administered with Weikang Capsules, 1.2 g/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the coagulation indexes, the levels of serum PGE₂, IL-17, PRA, 6-Keto-PGF1α, and ALD, and the hemostasis time and time of occult blood turning negative in two groups before and after treatment were compared. Results After treatment, the effective rates of the control group and the treatment group were 84.21% and 98.25%, respectively (P < 0.05). After treatment, the levels of serum PT, TT, and APTT in two groups were significantly decreased, while FIB was significantly increased, and the improvement of coagulation index was the most obvious in the treatment group (P < 0.05). After treatment, the level of serum PGE₂ in two groups were significantly increased, while the levels of IL-17, PRA, 6-Keto-PGF1α, and ALD were significantly decreased (P < 0.05), and the level of serum indexes in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the hemostatic time and occult blood turning negative time in the treatment group were earlier than those in the control group (P < 0.05). Conclusion The effect of Weikang Capsules combined with hemocoagulase in treatment of upper gastrointestinal bleeding is obvious, can not onlyimprove the blood coagulation function, but also improve the levels of serum PGE2, IL-17, PRA, 6-Keto-PGF1α and ALD.

R975

河南省医学科技攻关计划项目（201705362）