目的 探討胃康膠囊聯(lián)合蛇毒血凝酶注射液治療上消化道出血的臨床療效。方法 回顧性分析2020年3月—2021年3月在南陽市第二人民醫(yī)院治療的114例上消化道出血患者臨床資料，根據(jù)用藥的差別分為對照組和治療組，每組各57例。對照組患者給予蛇毒血凝酶注射液，立即靜注0.5 U，同時肌肉注射1 U，此后每隔6 h肌注1 U；治療組在對照組基礎(chǔ)上口服胃康膠囊，1.2 g/次，3次/d。兩組患者均治療7 d。觀察兩組患者臨床療效，比較治療前后兩組凝血指標(biāo)，血清前列腺素E₂（PGE₂）、白細胞介素-17（IL-17）、腎素活性（PRA）、6-酮前列腺素F1α（6-Keto-PGF1α）和醛固酮（ALD）水平及止血時間和潛血轉(zhuǎn)陰時間。結(jié)果 經(jīng)治療，對照組和治療組總有效率分別為84.21%和98.25%（P<0.05）。經(jīng)治療，兩組血清凝血酶原時間（PT）、凝血酶時間（TT）、活化部分凝血活酶時間（APTT）均降低，而纖維蛋白原（FIB）均升高（P<0.05），且治療組凝血指標(biāo)改善更明顯（P<0.05）。經(jīng)治療，兩組患者血清PGE2水平明顯升高，而IL-17、PRA、6-Keto-PGF1α、ALD水平明顯降低（P<0.05），且治療組血清學(xué)指標(biāo)水平明顯好于對照組（P<0.05）。經(jīng)治療，治療組在止血時間和潛血轉(zhuǎn)陰時間上均早于對照組（P<0.05）。結(jié)論 胃康膠囊聯(lián)合蛇毒血凝酶注射液治療上消化道出血效果明顯，不僅可改善機體凝血功能，還可促進血清PGE2、IL-17、PRA、6-Keto-PGF1α、ALD水平改善。

Objective To investigate the clinical effect of Weikang Capsules combined with Hemocoagulase Injection in treatment of upper gastrointestinal bleeding. Methods The clinical data of 114 patients with upper gastrointestinal bleeding treated in Nanyang Second People's Hospital from March 2020 to March 2021 were analyzed retrospectively and divided into control and treatment groups according to the difference of medication, and each group had 57 cases. Patients in the control group were administered with Hemocoagulase Injection, immediate intravenously dripped of 0.5 unit, meanwhile, 1 unit was injected intramuscularly, after that, 1 unit was injected intramuscularly every 6 hours. Patients in the treatment group were po administered with Weikang Capsules, 1.2 g/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, the coagulation indexes, the levels of serum PGE₂, IL-17, PRA, 6-Keto-PGF1α, and ALD, and the hemostasis time and time of occult blood turning negative in two groups before and after treatment were compared. Results After treatment, the effective rates of the control group and the treatment group were 84.21% and 98.25%, respectively (P < 0.05). After treatment, the levels of serum PT, TT, and APTT in two groups were significantly decreased, while FIB was significantly increased, and the improvement of coagulation index was the most obvious in the treatment group (P < 0.05). After treatment, the level of serum PGE₂ in two groups were significantly increased, while the levels of IL-17, PRA, 6-Keto-PGF1α, and ALD were significantly decreased (P < 0.05), and the level of serum indexes in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the hemostatic time and occult blood turning negative time in the treatment group were earlier than those in the control group (P < 0.05). Conclusion The effect of Weikang Capsules combined with hemocoagulase in treatment of upper gastrointestinal bleeding is obvious, can not onlyimprove the blood coagulation function, but also improve the levels of serum PGE2, IL-17, PRA, 6-Keto-PGF1α and ALD.

R975

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（201705362）