目的 探讨蒲元和胃胶囊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8月-2021年8月在濮阳市中医医院诊疗的80例重症患者应激性溃疡患者,随机分为对照组和治疗组,每组各40例。对照组患者静脉滴注西咪替丁注射液,0.2g加入生理盐水250mL,2次/d。在对照组的基础上,治疗组口服蒲元和胃胶囊,4粒/次,3次/d。两组患者治疗7周。观察两组患者临床疗效,比较治疗前后两组患者症状缓解时间,丙二醛(MDA)、超氧化物歧化酶(SOD)、缺血修饰白蛋白(IMA)水平,及血清胃泌素(MTL)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)水平。结果 治疗后,治疗组患者总有效率为97.50%,明显高于对照组的82.50%(P<0.05)。治疗后,治疗组呕血、柏油样便、腹痛、肌紧张缓解时间均明显短于对照组(P<0.05)。治疗后,两组MDA、IMA水平明显降低,SOD水平明显升高(P<0.05),且治疗组MDA、IMA和SOD水平明显好于对照组(P<0.05)。治疗后,两组MTL、IL-6、TNF-α、CRP水平明显下降(P<0.05),且治疗组明显低于对照组(P<0.05)。治疗期间,治疗组不良反应发生率明显低于对照组(7.49% vs 17.50%,P<0.05)。结论 蒲元和胃胶囊联合西咪替丁治疗疗效明显,能更好地改善症状,降低炎性反应,加快应激性溃疡面愈合。

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

河北省医学科学研究重点课题（20170147）