艾司奥美拉唑联合云南白药治疗急性非静脉曲张性上消化道出血的疗效  

Efficacy of esomeprazole combined with Yunnan Baiyao in the treatment of acute non-variceal upper gastrointestinal bleeding

作　　者：邢龙 吴丽颖[1] 王书海[1] 王金芝[1] XING Long;WU Liying;WANG Shuhai;WANG Jinzhi(Department of Gastroenterology,Huaibei People’s Hospital,Huaibei 235000,China)

机构地区：[1]淮北市人民医院消化内科,淮北235000

出　　处：《西北药学杂志》2024年第1期122-127,共6页Northwest Pharmaceutical Journal

基　　金：北京医卫健康公益基金会医学科学研究基金项目(编号:YWJKJJHKYJJ-A318)。

摘　　要：目的观察艾司奥美拉唑联合云南白药治疗急性非静脉曲张性上消化道出血(acute non-variceal upper gastrointestinal bleeding,ANVUGIB)的效果。方法将112例ANVUGIB患者随机分为对照组与观察组,每组56例。对照组患者给予艾司奥美拉唑治疗,观察组给予艾司奥美拉唑联合云南白药治疗。比较2组的临床疗效、止血情况与不良反应发生情况,检测并比较血红蛋白(hemoglobin,Hb)、红细胞计数(red blood cell count,RBC)和血清炎症因子水平。结果观察组12、24、48 h内的止血率显著高于对照组(P<0.05),但2组72 h内的止血成功率比较差异无统计学意义(P>0.05)。观察组的输血量显著少于对照组,止血时间与住院时间较对照组显著缩短(P<0.05);观察组的再出血率(1.79%)显著低于对照组(10.71%),P<0.05,但2组外科手术率比较差异无统计学意义(P>0.05)。治疗后,2组的RBC和Hb均显著升高,且观察组显著高于对照组(P<0.05);2组血清超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)均显著降低,且观察组显著低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论艾司奥美拉唑联合云南白药治疗ANVUGIB可抑制炎症反应并提高Hb水平,提高止血成功率、缩短出血时间并降低再出血率。Objective To observe the clinical efficacy of esomeprazole combined with Yunnan Baiyao in the treatment of acute nonvariceal upper gastrointestinal bleeding(ANVUGIB).Methods 112 patients with ANVUGIB were randomly divided into 2 groups:56 patients in control group treated by esomeprazole,56 patients in observation group treated by esomeprazole combined with Yunnan Baiyao.The clinical efficacy,hemostasis and adverse reactions of the 2 groups were compared,and the levels of hemoglobin(Hb),red blood cell count(RBC)and serum inflammatory factors were detected.Results Compared with the control group,the hemostasis rate within 12,24 and 48 hours of the observation group was significantly higher(P<0.05),but there was no significant difference in the hemostasis rate within 72 hours between the 2 groups(P>0.05).Compared with the control group.the blood transfusion volume of the observation group was significantly decreased(P<0.05),the hemostasis time and hospital stay were significantly shorter(P<0.05).The rebleeding rate was 1.79%and 10.71%in the observation group and the control group respectively,and the observation group was lower(P<0.05).There was no significant difference in the surgical operation rate between the 2 groups(P>0.05).After treatment,the RBC and Hb of the 2 groups were significantly increased,and the observation group was significantly higher than the control group(P<0.05).The serum levels of hs-CRP,IL-6,and TNF-αwere significantly decreased than before treatment in both groups,and the magnitude of reduction was more pronounced in the observation group compared with the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Esomeprazole combined with Yunnan Baiyao in the treatment of ANVUGIB can inhibit the inflammatory response,increase the Hb level,improve the success rate of hemostasis,shorten the bleeding time and reduce the rebleeding rate.

关 键 词：艾司奥美拉唑 云南白药 非静脉曲张性上消化道出血 炎症因子 

分 类 号：R975[医药卫生—药品]