【目的】 观察具有收敛止血、清热凉血功效的紫地合剂联合质子泵抑制剂（proton pump inhibitions，PPIs）治疗消化性溃 疡出血（peptic ulcer bleeding，PUB）的临床效果。【方法】 回顾性收集2019年12月至2023年5月在广州中医药大学第一附属医 院急诊病区住院的281例PUB患者，根据治疗方案的不同将其分为对照组143例和观察组138例。对照组患者在一般治疗基 础上给予PPIs治疗，观察组在对照组的基础上给予紫地合剂口服治疗，疗程为3 d。观察2组患者治疗前后格拉斯哥-布拉奇 福德出血评分（GBS）、血红蛋白量（HGB）、血小板总数（PLT）、血尿素氮（BUN）、血肌酐（Cr）、谷草转氨酶（AST）、谷丙转 氨酶（ALT）水平的变化情况，并比较 2 组患者的平均住院时间和临床疗效。【结果】（1）治疗 3 d 后，观察组的总有效率为 97.10%（134/138），对照组为 91.61%（131/143），组间比较（χ2检验），观察组的疗效优于对照组，差异有统计学意义（P＜ 0.05）。（2）治疗后，2组患者的GBS评分均较治疗前降低（P＜0.05），且观察组对GBS评分的降低作用优于对照组，差异有统 计学意义（P＜0.05）。（3）观察组的平均住院时间为（5.81 ± 1.02）d，较对照组的（6.13 ± 1.12）d 有所缩短，差异有统计学意义 （P＜0.05）。（4）治疗后，2组患者外周血HGB、PLT水平较治疗前升高（P＜0.05），BUN水平较治疗前降低（P＜0.05），且观察 组对外周血HGB、PLT水平的升高作用及对BUN水平的降低作用均明显优于对照组，差异均有统计学意义（P＜0.05）。（5）治 疗过程中，2组患者的外周血AST、ALT、Cr水平均未见升高，差异均无统计学意义（P＞0.05）。【结论】 紫地合剂联合PPIs治 疗PUB效果显著，有助于改善相关血常规和生化指标，缩短住院时间，其疗效优于单纯使用PPIs治疗。

Objective To observe the clinical effect of Zidi Mixture（with the actions of inducing astringency and arresting bleeding，clearing heat and cooling blood）combined with proton pump inhibitors（PPIs）in the treatment of peptic ulcer bleeding（PUB）. Methods A retrospective analysis was conducted in 281 PUB patients hospitalized in the emergency department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from December 2019 to May 2023. According to the treatment options，the patients were divided into a control group （143 cases）and an observation group（138 cases）. The patients in the control group were treated with PPIs together with routine basic treatment， and the patients in the observation group were treated with Zidi Mixture orally on the basis of treatment for the control group. The course of treatment lasted for 3 days. The changes of Glasgow-Blaschford Score（GBS）， and the levels of hemoglobin（HGB）， platelet count（PLT）， blood urea nitrogen（BUN），serum creatinine（Cr），aspartate aminotransferase（AST）and alanine aminotransferase（ALT） were observed before and after treatment in the two groups. Moreover，the average hospitalization time and clinical efficacy of the two groups were compared. Results（1）After 3 days of treatment，the total effective rate of the observation group was 97.10%（134/138）and that of the control group was 91.61%（131/143），and the intergroup comparison（tested by chi-square test）showed that the efficacy of the observation group was superior to that of the control group ，with a statistically significant difference（P＜0.05）.（2）After treatment，the GBS scores in the two groups were decreased as compared with those before treatment（P＜0.05），and the decrease of GBS scores in the observation group was superior to that in the control group，the difference being statistically significant（P＜ 0.05）.（3）The average hospitalization time in the observation group was（5.81 ± 1.02）days，which was shorter than that in the control group （[ 6.13 ± 1.12）days]，and the difference was statistically significant（P＜0.05）. （4）After treatment，the peripheral HGB and PLT levels in the two groups were higher than those before treatment （P＜0.05），and the BUN level was lower than that before treatment（P＜0.05），and the effects on increasing peripheral blood HGB and PLT levels and on decreasing BUN level in the observation group were significantly superior to those in the control group，the differences being statistically significant（P＜0.05）. （5）In the course of treatment，the peripheral AST，ALT，Cr levels of the two groups were not elevated，and the differences were insignificant（P＞0.05）. Conclusion Zidi Mixture combined with PPIs is effective in the treatment of PUB，which helps to improve relevant indicators of blood routine test and biochemical indexes and shorten hospitalization time， and its efficacy is stronger than that of PPIs alone.

R259.732

国家科技部重大专项课题（编号：2018YFC1705900）