Treatment effect of esomeprazole magnesium combined with hemocoagulase on upper gastrointestinal hemorrhage

doi:10.3969/j.issn.1674-8115.2022.11.009

Abstract

Abstract:

Objective ·To observe the total clinical effective rate of esomeprazole magnesium combined with hemocoagulase in the treatment of upper gastrointestinal hemorrhage (UGH) and its influence on upper gastrointestinal mucosa, inflammatory response, stress response and hemorheology. Methods ·A total of 146 patients with UGH, admitted to West China Airport Hospital, Sichuan University from March 2020 to March 2021, were divided into combined group and control group by using the random number table method, with 73 cases in each group. On the basis of conventional treatment, patients in the control group were treated with esomeprazole magnesium, and patients in the combined group were given esomeprazole magnesium combined with hemocoagulase. The total clinical effective rate after 5 d of treatment, as well as serum related factors [serum prostaglandin E₂ (PGE₂), and 6-keto-prostaglandin F_1α (6-Keto-PGF_1α)], stress indicators [nitric oxide (NO), cortisol (COR), and gastrin (GAS)], serum inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α)] and hemorheological indicators [whole blood high-shear viscosity, whole blood low-shear viscosity, erythrocyte sedimentation rate, and hematocrit] before and after treatment were compared between the two groups. Results ·The total clinical effective rate of 95.89% in the combined group was higher than 86.30% in the control group (P=0.042). After 5 d of treatment, the stress indicator (NO, COR, and GAS) levels, serum inflammatory factors (CRP, IL-6, and TNF-α), erythrocyte sedimentation rate, and 6-Keto-PGF_1α in the combined group were lower than those in the control group (all P=0.000). The whole blood high-shear viscosity, whole blood low-shear viscosity, hematocrit and PGE₂ levels were higher in the combined group compared to the control group (all P=0.000). Conclusion ·The clinical effect of esomeprazole magnesium combined with hemocoagulase is significant in the treatment of UGH, which may be related to the effect of reducing body′s stress response and inflammatory response, changing hemorheology and protecting upper gastrointestinal mucosa.

Key words: upper gastrointestinal hemorrhage, hemocoagulase, esomeprazole magnesium, clinical effect

CLC Number:

R573.2

TANG Chuang, ZHANG Xin, ZHANG Ting. Treatment effect of esomeprazole magnesium combined with hemocoagulase on upper gastrointestinal hemorrhage[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(11): 1576-1581.

Figures/Tables 6

TrendMD

References 18

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Item	Joint group （n=73）	Control group （n=73）	t/χ² value	P value
Gender/n （%）			0.111	0.739
Male	42 （57.5）	40 （54.8）
Female	31 （42.5）	33 （45.2）
Age/year	38.56±7.83	39.12±7.62	0.438	0.662
Cause of hemorrhage/n （%）			1.335	0.721
Erosive gastritis	19 （26.0）	17 （23.3）
Gastric ulcer	15 （20.6）	21 （28.8）
Digestive tract tumor	16 （21.9）	14 （19.2）
Duodenal ulcer	23 （31.5）	21 （28.8）
Antithrombotic drug therapy/n （%）			1.043	0.307
Yes	31 （42.5）	25 （34.2）
No	42 （57.5）	48 （65.8）
Modified Forrest grade/n （%）			0.731	0.866
Ⅰb	5 （6.8）	6 （8.2）
Ⅱa	15 （20.5）	14 （19.2）
Ⅱb	26 （35.6）	30 （41.1）
Ⅱc	27 （37.0）	23 （31.5）

Item	Joint group （n=73）	Control group （n=73）	t/χ² value	P value
Gender/n （%）			0.111	0.739
Male	42 （57.5）	40 （54.8）
Female	31 （42.5）	33 （45.2）
Age/year	38.56±7.83	39.12±7.62	0.438	0.662
Cause of hemorrhage/n （%）			1.335	0.721
Erosive gastritis	19 （26.0）	17 （23.3）
Gastric ulcer	15 （20.6）	21 （28.8）
Digestive tract tumor	16 （21.9）	14 （19.2）
Duodenal ulcer	23 （31.5）	21 （28.8）
Antithrombotic drug therapy/n （%）			1.043	0.307
Yes	31 （42.5）	25 （34.2）
No	42 （57.5）	48 （65.8）
Modified Forrest grade/n （%）			0.731	0.866
Ⅰb	5 （6.8）	6 （8.2）
Ⅱa	15 （20.5）	14 （19.2）
Ⅱb	26 （35.6）	30 （41.1）
Ⅱc	27 （37.0）	23 （31.5）

Item	Joint group（n=73）	Control group（n=73）	χ² value	P value
Efficacy/n （%）			2.110	0.035
Marked improvement	48 （65.8）	37 （50.7）
Moderate improvement	22 （30.1）	26 （35.6）
No improvement	3 （4.1）	10 （13.7）
Total effective rate/%	95.89	86.30	4.138	0.042

Item	Joint group（n=73）	Control group（n=73）	χ² value	P value
Efficacy/n （%）			2.110	0.035
Marked improvement	48 （65.8）	37 （50.7）
Moderate improvement	22 （30.1）	26 （35.6）
No improvement	3 （4.1）	10 （13.7）
Total effective rate/%	95.89	86.30	4.138	0.042

Item	Joint group （n=73）		Control group （n=73）
Item	Pre-treatment	Post-treatment for 5 d	Pre-treatment	Post-treatment for 5 d
PGE₂/（pg·mL^-1）	211.54±30.43	308.62±25.46^①②	211.95±31.73	279.89±27.54^①
6-Keto-PGF_1α/（pg·mL^-1）	185.42±22.86	117.95±19.51^①②	184.04±21.31	140.45±20.63^①