目的 观察奥曲肽联合雷贝拉唑治疗非静脉曲张性上消化道出血的临床疗效,为非静脉曲张性上消化道出血的治疗提供借鉴。方法 选取在2010年4月到2013年6月以来西安市第九医院就诊的非静脉曲张性上消化道出血患者为研究对象,并根据治疗方式随机分为3组,奥曲肽组、雷贝拉唑组和联合组,观察患者临床疗效、生命体征、出血停止时间。结果 3组患者连续治疗5 d后,出血时间奥曲肽组为(28±6)h,雷贝拉唑组为(26±5)h,联合组为(20±5)h,雷贝拉唑组短于奥曲肽组,联合组短于单独用药组,差异具有统计学意义(P<0.05)。血红蛋白奥曲肽组、雷贝拉唑组、联合组分别为(99±15)、(103±16)、(115±11)g/L,联合组与其他两组比较差异显著(P<0.05)。联合组患者白细胞明显下降,下降程度明显高于奥曲肽组和雷贝拉唑组,差异有统计学意义(P<0.05)。联合组临床症状改善情况明显优于奥曲肽组和雷贝拉唑组,黑便、呕血、发热病例数明显减少,差异有统计学意义(P<0.05)。总有效率比较,奥曲肽组为65.0%,雷贝拉唑组为85.0%,两组比较差异有显著性(P<0.05),联合组总有效率为97.5%,与奥曲肽组、雷贝拉唑组比较,差异均有显著性(P<0.05)。治疗过程中联合组1例患者出现轻微恶心、呕吐症状,单药组患者无不良反应发生。结论 治疗非静脉曲张性上消化道出血,雷贝拉唑临床疗效优于奥曲肽,奥曲肽联合雷贝拉唑可明显增强止血效果。
Objective To investigate the clinical efficacy of Octreotide combined with Rabeprazole in treatment of non-variceal gastrointestinal bleeding, in order to provide references for non-variceal gastrointestinal bleeding. Methods The patients with non-variceal gastrointestinal bleeding from April 2010 to June 2013 in The Ninth Hospital of Xi'an City were chosen and divided into three groups, such as Octreotide group, Rabeprazole group, and the combined group. The clinical symptoms, vital signs, bleeding stop time of three groups were observed. Results After treatment for 5 days, bleeding time in Octreotide group was (28 ± 6) h and (26 ± 5) h in Rabeprazole group and combined group (20 ± 5) h, Rabeprazole group is shorter than that of the octreotide group, the combined group was shorter than that of single drug group, the difference has statistical significance (P < 0.05). Hemoglobin in octreotide group, rabeprazole group and combination group were (99 ± 15), (103 ± 16), (115 ± 11) g/L respectively, combined group and the other two groups had significant difference (P < 0.05). The improvement of clinical symptoms of the combined group was obviously better than that of the Octreotide group and Rabeprazole group, melena, hematemesis, fever cases reduced significantly, the difference was statistically significant (P < 0.05). Comparison of total efficiency, Octreotide group was 65.0%, rabeprazole group was 85.0%, the difference between the two groups is significant (P < 0.05), total efficiency of combined group was 97.5%, compared with Octreotide group, Rabeprazole group, the differences were significantly (P < 0.05). During the course of treatment, 1 cases of patients with mild nausea and vomiting symptoms, no adverse reactions occurred in the single drug group. Conclusion In the treatment of non variceal upper gastrointestinal bleeding, Rabeprazole is superior to the clinical efficacy of Octreotide, the combined application of Octreotide and Rabeprazole can significantly enhance the hemostatic effect.