目的 探讨卡络磺钠联合雷贝拉唑治疗溃疡性上消化道出血的临床疗效。方法 选取2018年1月—2021年12月在梧州市工人医院住院治疗的74例溃疡性上消化道出血患者，按照随机数字法将所有患者分为对照组和治疗组，每组各37例。对照组早晨口服雷贝拉唑钠肠溶胶囊，20 mg/次，1次/d。治疗组在对照组的基础上静滴滴注注射用卡络磺钠，60 mg加入0.9%氯化钠注射液250 mL中稀释，1次/d。两组均连续用药7 d。观察两组的临床疗效，比较两组腹胀、腹痛、头晕、烧心症状缓解时间及治疗前后血清丙二醇（MDA）、抗利尿激素（ADH）、皮质醇（COR）、白细胞介素6（IL-6）、白细胞介素17（IL-17）、肿瘤坏死因子α（TNF-α）、C反应蛋白（CRP）水平的变化情况和不良反应。结果 治疗后，治疗组总有效率是97.29%，显著高于对照组的81.08%（P＜0.05）。经治疗，治疗组腹胀、腹痛、头晕、烧心症状缓解时间均显著短于对照组（P＜0.05）。治疗后，两组MDA、ADH、COR水平均较治疗前显著降低（P＜0.05），且治疗后治疗组MDA、ADH、COR水平低于对照组（P＜0.05）。治疗后，两组血清IL-6、IL-17、TNF-α、CRP水平均较治疗前显著降低（P＜0.05），且治疗后，治疗组血清学指标水平低于对照组（P＜0.05）。治疗组患者不良反应发生率是8.11%，显著低于对照组患者的18.92%（P＜0.05）。结论 卡络磺钠联合雷贝拉唑治疗溃疡性上消化道出血可有效提高治疗效果，并能极大地缓解患者临床症状，改善机体氧化应激反应，降低炎性因子水平，具有一定的临床推广应用价值。

Objective To investigate the clinical of carbazochrome sodium combined with rabeprazole in treatment of ulcerative upper gastrointestinal bleeding. Methods A total of 74 patients with ulcerative upper gastrointestinal bleeding hospitalized in Wuzhou Worker's Hospital from January 2018 to December 2021 were selected, and all patients were divided into control group and treatment group according to random number method, with 37 cases in each group. Patients in the control group were po administered with Rabeprazole Sodium Enteric-coated Capsules, 20 mg/time, once daily. Patients in the treatment group were iv administered with Carbazochrome Sodium Sulfonare for injection on the basis of the control group, 60 mg was added into 0.9% sodium chloride injection 250 mL, once daily. Both groups were treated for 7 d. The clinical efficacy of the two groups was observed. The relief time of abdominal distention, abdominal pain, dizziness and heartburn were compared. The changes of serum MDA, ADH, COR, IL-6, IL-17, TNF-α, and CRP before and after treatment, and adverse reactions were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 97.29%, significantly higher than that in the control group (81.08%, P < 0.05). After treatment, the relief time of abdominal distension, abdominal pain, dizziness, and heartburn in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, the levels of MDA, ADH and COR in two groups were significantly lower than those before treatment (P < 0.05), and the levels of MDA, ADH, and COR in treatment group were lower than those in control group (P < 0.05). After treatment, the levels of serum IL-6, IL-17, TNF-α, and CRP in two groups were significantly lower than those before treatment (P < 0.05), and the serum indexes in treatment group were lower than those in control group (P < 0.05). The incidence of adverse reactions in treatment group was 8.11%, significantly lower than 18.92% in control group (P < 0.05). Conclusion Carbazochrome sodium combined with rabeprazole can effectively improve the therapeutic effect in treatment of ulcerative upper gastrointestinal bleeding, and can greatly relieve the clinical symptoms of patients, improve the oxidative stress response of the body, and reduce the level of inflammatory factors, which has a certain clinical application value.

R975

梧州市科学研究与技术开发计划项目(201702059)