目的 探讨裸花紫珠颗粒和注射用卡络磺钠联合治疗上消化道出血的临床效果。方法 选取2023年1月—2025年1月江南大学附属医院收治的88例上消化道出血患者，按随机数字表法将患者分为对照组（44例）和治疗组（44例）。对照组静脉滴注注射用卡络磺钠，60 mg加入0.9%氯化钠注射液250 mL稀释，1次/d。治疗组在对照组基础上口服裸花紫珠颗粒，1袋/次，4次/d。两组连续治疗7 d。比较两组临床疗效、临床症状消失时间、凝血指标和再出血情况。结果 治疗组的总有效率为95.45%，高于对照组的总有效率77.27%（P＜0.05）。与对照组相比，治疗组黑便、腹痛、呕血、腹胀症状消失时间更短（P＜0.05）。治疗后，两组部分活化凝血活酶时间（APTT）、凝血酶时间（TT）、凝血酶原时间（PT）显著降低，纤维蛋白原（FIB）显著升高（P＜0.05）；治疗后，治疗组的APTT、TT、PT低于对照组，FIB高于对照组（P＜0.05）。治疗后，两组血清白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平显著降低（P＜0.05）；治疗后，治疗组血清IL-1β、IL-6、TNF-α水平低于对照组（P＜0.05）。随访3个月，治疗组患者再出血率低于对照组（P＜0.05）。结论 裸花紫珠颗粒与注射用卡络磺钠联合治疗上消化道出血能够显著提升疗效，减轻患者的临床症状，改善其凝血指标，降低血清炎症因子和再出血率。

Objective To explore the clinical efficacy of the combination therapy of Luohua Zizhu Granules and Carbazochrome Sodium Sulfonate for injection in treatment of upper gastrointestinal bleeding. Methods A total of 88 patients with upper gastrointestinal bleeding admitted to the Affiliated Hospital of Jiangnan University from January 2023 to January 2025 were selected and divided into control group (44 cases) and treatment group (44 cases) according to the random number table method. The control group were iv administered with Carbazochrome Sodium Sulfonate for injection, 60 mg diluted with 250 mL of 0.9% sodium chloride injection, once daily. The treatment group received oral administration with Luohua Zizhu Granuleson the based on the control group, 1 bag/time, 4 times daily. Two groups were treated continuously for 7 d. The clinical efficacy, disappearance time of clinical symptoms, coagulation indicators, and rebleeding were compared between two groups. Results The total effective rate of the treatment group was 95.45%, which was higher than the total effective rate of 77.27% in the control group (P < 0.05). The disappearance time of symptoms such as black stool, abdominal pain, vomiting blood, and abdominal distension in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the partially activated thromboplastin time (APTT), thrombin time (TT), and prothrombin time (PT) of two groups significantly decreased, while fibrinogen (FIB) significantly increased (P < 0.05). APTT, TT, and PT of the treatment group were lower than those of the control group, while FIB was higher than that of the control group (P < 0.05). After treatment, the serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were significantly reduced in two groups (P < 0.05), and the serum levels of IL-1β, IL-6, and TNF-α in the treatment group were significantly lower than those in the control group (P < 0.05). After a 3-month follow-up, the treatment group had a lower rebleeding rate than that of the control group (P < 0.05). Conclusion The combination of Luohua Zizhu Granules and Carbazochrome Sodium Sulfonate for injection in treatment of upper gastrointestinal bleeding can significantly improve the clinical efficacy of patients, alleviate clinical symptoms, improve coagulation indicators, and reduce serum inflammatory factors and rebleeding rates.

R974