健脾止血方联合奥美拉唑治疗对上消化道出血患者炎症反应凝血功能的影响

Effect of Jianpi Zhijing Prescription Combined with Omeprazole on Inflammation and Coagulat ion Function in Patients with Upper Gastrointestinal Bleeding

目的:研究健脾止血方联合奥美拉唑治疗对上消化道出血患者炎症反应、凝血功能的影响。方法:以平顶山市第二人民医院宝丰分院收治的82例上消化道出血患者(2021年5月—2023年1月)为研究对象,随机数字表法分为对照组(41例)、联合组(41例)。对照组采用奥美拉唑治疗,联合组采用健脾止血方联合奥美拉唑治疗。比较两组临床疗效、治疗前及治疗5d后Rockall评分、凝血功能指标[凝血酶时间、活化部分凝血活酶时间、凝血酶原时间、纤维蛋白原]、血清超敏C反应蛋白、肿瘤坏死因子-α、核转录因子κB抑制蛋白α、p50水平、不良反应发生率。结果:联合组临床总有效率(97.56%)高于对照组(80.49%)(P<0.05);治疗5 d后,联合组Rockall评分低于对照组(P<0.05);治疗5 d后,联合组凝血酶时间、活化部分凝血活酶时间、凝血酶原时间值低于对照组,纤维蛋白原水平高于对照组(P<0.05);治疗5 d后,联合组血清超敏C反应蛋白、肿瘤坏死因子-α水平低于对照组,核转录因子κB抑制蛋白α、p50水平高于对照组(P<0.05);联合组不良反应总发生率(12.20%)与对照组(7.32%)相比,差异无统计学意义(P>0.05)。结论:采用健脾止血方与奥美拉唑联合治疗上消化道出血患者可有效降低炎症反应及危险度,改善凝血功能,提高疗效,有一定安全性。

Objective: To study the effect of Jianpi Zhixue Recipe combined with omeprazole on inflammatory re-sponse and coagulation function in patients with upper gastrointestinal bleeding. Methods: 82 patients with upper gas-trointestinal bleeding admitted to Baofeng Branch of Pingdingshan Second People’s Hospital (May 2021 - January 2023) were used as the research subjects. The random number table method was divided into control group (41 cases), combined group. group (41 cases). The control group was treated with omeprazole, and the combination group was treat-ed with Jianpi Zhixue Recipe combined with omeprazole. The clinical efficacy, Rockall score before treatment and after 5 days of treatment, coagulation function indicators [thrombin time, activated partial thromboplastin time, prothrombin time, fibrinogen], serum high-sensitivity C-reactive protein, and tumor necrosis factor were compared between the two groups. Nuclear transcription factor κB inhibitory protein α, p50 levels, incidence of adverse reactions. Results: The total clinical effective rate of the combination group (97.56%) was higher than that of the control group (80.49%) (P<0.05);after 5 days of treatment, the Rockall score of the combination group was lower than that of the control group (P<0.05);after 5 days of treatment, The thrombin time, activated partial thromboplastin time, and prothrombin time in the combination group were lower than those in the control group, and the fibrinogen level was higher than that in the control group (P<0.05);after 5 days of treatment, the serum high-sensitivity C-reactive protein in the combination group , the level of tumor necrosis factor-α was lower than that of the control group, and the levels of nuclear tran-scription factor κB inhibitory protein α and p50 were higher than those of the control group (P<0.05);the total inci-dence of adverse reactions in the combination group (12.20%) was higher than that in the control group (7.32%). Com-pared, the difference was not statistically significant (P>0.05). Conclusion: The combination of Jianpi Zhixue Recipe and omeprazole in the treatment of patients with upper gastrointestinal bleeding can effectively reduce the inflammatory response and risk, improve coagulation function, improve the efficacy, and has certain safety.