Comparison Of Efficacy And Safety Of Lansoprazole And Combined Use Of Drugs In The Treatment Of Peptic Ulcer Bleeding

Objective:By comparing the efficacy and safety of lansoprazole for injection and combined with gastric mucosal protective agents and hemostatic agents in the treatment of patients with peptic ulcer complicated with upper gastrointestinal bleeding after successful endoscopic hemostasis.In order to find a better and more economical treatment scheme for this disease,and to provide corresponding basis for clinical rational use of drugs.Methods:The criteria of inclusion and exclusion were determined by referring to the relevant literature.96 patients with peptic ulcer complicated with upper gastrointestinal bleeding which were treated in a third-class hospital were divided into the observation group（n=50）and the control group（n=46）from December 2019 to September 2020.The observation group was treated with lansoprazole for injection and the control group was treated with lansoprazole for injection（30mg,ivgtt,bid）combined with oral administration of gastric mucosal protective agent magnesium aluminum carbonate granule（0.5g,po,tid）and intravenous infusion of hemostatic drug Baimei snake venom hemagglutinin powder（2ku,ivgtt,qd）,the clinical efficacy and adverse reactions of the two groups were observed 5 days later,and the related indexes of health economics were analyzed.Results:There was no significant difference in the overall curative effect between the two groups（P>0.814）.There was no apparent difference in heart rate,blood pressure,red blood cell count,hemoglobin,hematocrit,blood urea nitrogen and blood transfusion between the two groups（P>0.05）.The heart rate of patients in the observation group decreased from 85.28 beats/min to 73.72 beats/min,while the patients in the control group decreased from 87.40 beats/min to 74.16 beats/min.The systolic blood pressure increased from mean 116.98mm Hg to 121.86mm Hg in the observation group,and from 120.02mm Hg to 127.58mm Hg in the control group.There was no visible difference between the two groups.The diastolic blood pressure increased from mean 73.54mm Hg to 79.58mm Hg in the observation group,and from72.00mm Hg to 78.38mm Hg in the control group.There was no apparent difference between the two groups.The red blood cell count of patients in the observation group decreased from 4.43×10¹²/L to 4.12×10¹²/L,while the control group decreased from 4.17×10¹²/L to 3.87×10¹²/L,which was no obvious difference（P>0.05）.The hemoglobin of the observation group decreased from the mean 133.50g/L to124.18g/L,while that of the control group decreased from the mean 127.18g/L to116.64g/L,and there was no significant difference（P>0.05）.The hematocrit of patients in the observation group decreased from 39.60%to 36.91%,while that of patients in the control group decreased from 36.71%to 34.96%.There was no visible difference（0.078vs0.184）.The blood urea nitrogen in the observation group decreased from the mean 6.09mmol/L to 4.18 mmol/L,while that in the control group decreased from the mean 7.31mmol/L to 4.41 mmol/L,and there was no significant difference（0.056vs0.305）.There was one case of blood transfusion in the observation group and one case in the control group,and there was no obvious difference between the two groups（P>0.05）.There was no significant difference in the number of adverse reactions between the two groups（P>0.05）.There was no significant difference in the monitoring indexes of liver function,renal function and urine routine between the two groups（P>0.05）.The mean value of glutamic pyruvic transaminase in the observation group decreased from 23.69U/L to 22.89 U/L,while that in the control group increased from mean 26.06U/L to 20.63 U/L,which was no significant difference（P>0.05）.The mean value of glutamic oxaloacetic transaminase in the observation group decreased from 21.28U/L to 19.83U/L,while that in the control group increased from21.91U/Lto18.92U/L.There was no significant difference between the two groups（P>0.05）.The total bilirubin in the observation group decreased from 14.38μmol/L to 12.53μmol/L,while that in the control group decreased from 12.57μmol/L to 11.59μmol/L.Lactate dehydrogenase in the observation group decreased from mean 159.38IU/L to 142.62 IU/L,while in the control group,lactate dehydrogenase decreased from mean 165.71IU/L to 150.95IU/L,and there was no significant difference（P>0.05）.The alkaline phosphatase in the observation group decreased from 66.73IU/L to 62.90 IU/L,while that in the control group decreased from 70.83IU/L to 69.41IU/L.There was no significant difference between the two groups（P>0.05）.The mean value of glutamyl transpeptidase in the observation group decreased from 23.81U/L to 20.35 U/L,while that in the control group decreased from mean 28.73U/L to 25.86 U/L.there was no significant difference between the two groups（P<0.05,P<0.05）.Creatinine increased from 64.38μmol/L to 66.99μmol/L in observation group,while glutamyl transpeptidase increased from 67.05μmol/L to 72.75μmol/L in control group.The number of urine routine glucose negative patients in the observation group decreased from 49 to 47,while in the control group,the number of urine routine glucose negative patients did not change,still 42,there was no significant difference（P<0.01）.The number of urinary routine protein negative patients in the observation group increased from 45 to 47,while that in the control group increased from 41 to 44.There was no significant difference between the two groups（P>0.05）.There was no difference in electrolytes except calcium concentration between the two groups.The serum sodium concentration in the observation group increased from mean138.64mmol/L to 139.84 mmol/L,while that in the control group increased from mean 138.58mmol/L to 139.78 mmol/L,with no significant difference（P>0.05）.The serum potassium concentration in the observation group increased from the mean3.95mmol/L to 4.01mmol/L,while that in the control group decreased from the mean4.02mmol/L to 3.97mmol/L.there was no significant difference between the two groups（P>0.05）.The mean value of serum calcium concentration in the observation group did not change to 2.26 mmol/L,while the serum calcium concentration in the control group decreased from 2.26mmol/L to 2.19mmol/L（0.044）,but the calcium concentrations in both groups were in the normal range.The concentration of magnesium ion in serum of patients in the observation group increased from0.83mmol/L to 0.84 mmol/L,and that in the control group,the concentration of magnesium ion in serum increased from mean 0.83mmol/L to 0.86 mmol/L,and there was no significant difference（P>0.05）.There was a significant difference in the treatment cost between the two groups（P<0.01）.The average cost of the observation group was 4118.01 yuan,while that of the control group was 5526.23 yuan.Conclusion:lansoprazole injection can achieve the same effect as the combination of gastric mucosal protective agents and hemostatic drugs in the treatment of peptic ulcer with bleeding,but it can obviously save the cost and it is safe.