目的 探討健胃愈瘍顆粒聯(lián)合西咪替丁治療重癥患者應(yīng)激性潰瘍的臨床療效。方法 選擇2019年6月—2022年5月上海市楊浦區(qū)中心醫(yī)院收治的103例應(yīng)激性潰瘍患者，隨機分為對照組（51例）和治療組（52例）。對照組靜脈滴注西咪替丁注射液，0.2 g加入250 mL生理鹽水中，2次/d。治療組在對照組基礎(chǔ)上口服健胃愈瘍顆粒，9 g/次，3次/d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀評分，血清C反應(yīng)蛋白（CRP）、腫瘤壞死因子-α（TNF-α）、胃泌素（MTL）、缺血修飾白蛋白（IMA）、超氧化物歧化酶（SOD）和丙二醛（MDA）水平及不良反應(yīng)。結(jié)果 治療后，治療組臨床有效率明顯高于對照組（96.15% vs 84.31%，P＜0.05）。治療后，治療組臨床癥狀評分均明顯比對照組低（P＜0.05）。治療后，兩組血清CRP、TNF-α、MTL、IMA和MDA水平均明顯降低，而血清SOD水平明顯升高（P＜0.05），且治療組血清指標(biāo)水平均明顯好于對照組（P＜0.05）。治療期間，治療組患者不良反應(yīng)發(fā)生率為3.85%，對照組為17.65%，兩組比較差異有統(tǒng)計學(xué)意義（P＜0.05）。結(jié)論 健胃愈瘍顆粒聯(lián)合西咪替丁治療重癥患者應(yīng)激性潰瘍的臨床療效比單純應(yīng)用西咪替丁好，有助于臨床癥狀的減輕，改善炎性因子水平，且安全性較好。

Objective To investigate the clinical efficacy of Jianwei Yuyang Granules combined with cimetidine in treatment of stress ulcer. Methods Patients (103 cases) with stress ulcer in Shanghai Yangpu District Central Hospital from June 2019 to May 2022 were randomly divided into control (51 cases) and treatment (52 cases) group. Patients in the control group were iv administered with Cimetidine Injection, 0.2 g added into normal saline 250 mL, twice daily. Patients in the treatment group were po administered with Jianwei Yuyang Granules on the basis of the control group, 9 g/time, three times daily. After treatment, the clinical evaluation was evaluated, and the clinical symptom scores, the levels of serum CRP, TNF-α, MTL, IMA, SOD and MDA in two groups before and after treatment were compared, as well as adverse reactions. Results After treatment, the clinical effective rate of the treatment group was significantly higher than that of the control group (96.15% vs 84.31%, P< 0.05). After treatment, the clinical symptom scores of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the levels of serum CRP, TNF-α, MTL, IMA and MDA were significantly decreased, while the level of serum SOD was significantly increased in two groups (P < 0.05), and the levels of serum indexes in the treatment group were significantly better than those in the control group (P < 0.05). During the treatment, the incidence of adverse reactions was 3.85% in the treatment group and 17.65% in the control group, there was significant difference between the two groups (P < 0.05). Conclusion The clinical efficacy of Jianwei Yuyang Granules combined with cimetidine in treatment of stress ulcer in severe patients is better than that of cimetidine alone, which is helpful to alleviate clinical symptoms, improve the level of inflammatory factors, and is safe.

R975

上海市楊浦區(qū)衛(wèi)生和計劃生育委員會科研課題(YP18M24)