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目的:观察木瓜三萜片与奥美拉唑胶囊联用治疗非甾体抗炎药致上消化道出血的疗效与安全性及其对胃黏膜攻击因子(ICAM-1和PAF)和防御因子(COX-1、PGE2、EGF和TFF1)水平的影响。方法:将124例非甾体抗炎药致上消化道出血患者完全随机分成2组:对照组62例、治疗组62例。对照组单用奥美拉唑治疗,治疗组采用木瓜三萜片联合奥美拉唑治疗,2组疗程均为4周。观察2组治疗效果及安全性,治疗前后取静脉血采用ELISA试剂盒检测血清中ICAM-1、PAF和COX-1、PGE2、EGF、TFF1水平的变化。结果:治疗后,治疗组症状积分(腹胀、腹痛、反酸、嗳气等)明显低于对照组,总有效率(95.16%)明显高于对照组(79.03%);治疗前两组血清中ICAM-1、PAF和COX-1、PGE2、EGF、TFF1水平没有差异,分别用相应的药物治疗后,对照组弱有改善,但是与木瓜三萜联用后有显著改善,未见明显不良反应,与对照组比较具有显著性差异。结论:木瓜三萜片与奥美拉唑胶囊联用治疗非甾体抗炎药引起的上消化道出血疗效更好,无明显不良反应,值得临床推广应用。
Objective: To observe the curative effect and safety of papaya triterpene tablets combined with omeprazole capsule in the treatment of upper gastrointestinal bleeding caused by non-steroidal anti-inflammatory drugs and its effect on gastric mucosal attack factor (ICAM-1 and PAF) and defense factor COX-1, PGE2, EGF and TFF1) levels. Methods: 124 cases of non-steroidal anti-inflammatory drugs induced upper gastrointestinal bleeding were randomly divided into two groups: control group of 62 patients, the treatment group of 62 patients. The control group was treated with omeprazole alone. The treatment group was treated with papaya triterpene and omeprazole, and the two courses of treatment were 4 weeks. The curative effect and safety of the two groups were observed. Changes of serum ICAM-1, PAF and COX-1, PGE2, EGF and TFF1 levels in venous blood before and after treatment were detected by ELISA kit. Results: After treatment, the symptom score (bloating, abdominal pain, acid reflux, belching, etc.) of the treatment group was significantly lower than that of the control group, and the total effective rate (95.16%) was significantly higher than that of the control group (79.03% -1, PAF and COX-1, PGE2, EGF, TFF1 levels were not significantly different after treatment with the corresponding drug, the control group weak improvement, but with papaya triterpene significantly improved after treatment, no significant adverse reactions, Compared with the control group, there was a significant difference. Conclusion: Combination of papaya triterpene tablets and omeprazole capsule in the treatment of upper gastrointestinal bleeding caused by NSAIDs is better and no obvious adverse reactions are observed, which is worthy of clinical application.