目的 探討卡絡(luò)磺鈉聯(lián)合雷貝拉唑治療潰瘍性上消化道出血的臨床療效。方法 選取2018年1月—2021年12月在梧州市工人醫(yī)院住院治療的74例潰瘍性上消化道出血患者，按照隨機數(shù)字法將所有患者分為對照組和治療組，每組各37例。對照組早晨口服雷貝拉唑鈉腸溶膠囊，20 mg/次，1次/d。治療組在對照組的基礎(chǔ)上靜滴滴注注射用卡絡(luò)磺鈉，60 mg加入0.9%氯化鈉注射液250 mL中稀釋，1次/d。兩組均連續(xù)用藥7 d。觀察兩組的臨床療效，比較兩組腹脹、腹痛、頭暈、燒心癥狀緩解時間及治療前后血清丙二醇（MDA）、抗利尿激素（ADH）、皮質(zhì)醇（COR）、白細胞介素6（IL-6）、白細胞介素17（IL-17）、腫瘤壞死因子α（TNF-α）、C反應(yīng)蛋白（CRP）水平的變化情況和不良反應(yīng)。結(jié)果 治療后，治療組總有效率是97.29%，顯著高于對照組的81.08%（P＜0.05）。經(jīng)治療，治療組腹脹、腹痛、頭暈、燒心癥狀緩解時間均顯著短于對照組（P＜0.05）。治療后，兩組MDA、ADH、COR水平均較治療前顯著降低（P＜0.05），且治療后治療組MDA、ADH、COR水平低于對照組（P＜0.05）。治療后，兩組血清IL-6、IL-17、TNF-α、CRP水平均較治療前顯著降低（P＜0.05），且治療后，治療組血清學(xué)指標(biāo)水平低于對照組（P＜0.05）。治療組患者不良反應(yīng)發(fā)生率是8.11%，顯著低于對照組患者的18.92%（P＜0.05）。結(jié)論 卡絡(luò)磺鈉聯(lián)合雷貝拉唑治療潰瘍性上消化道出血可有效提高治療效果，并能極大地緩解患者臨床癥狀，改善機體氧化應(yīng)激反應(yīng)，降低炎性因子水平，具有一定的臨床推廣應(yīng)用價值。

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

梧州市科學(xué)研究與技術(shù)開發(fā)計劃項目(201702059)