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目的 探讨枸橼酸铋钾联合法莫替丁对消化性溃疡的治疗效果及对过氧化脂(LPO)、丙二醛(MDA)、生长抑素(SS)水平的影响.方法 选取2018年1月至2019年5月于浙江省慈溪市慈林医院接受治疗的消化性溃疡患者150例,按随机数字表法分为法莫替丁组、联合治疗组,每组75例,法莫替丁组患者使用法莫替丁进行治疗,联合治疗组患者使用枸橼酸铋钾联合法莫替丁进行治疗.对两组患者H+-K+-ATP酶活性、胃内酸碱值、胃酸分泌功能进行检测,酶联免疫吸附试验法检测肿瘤坏死因子(TNF)-α、白细胞介素(IL)-7、超敏C反应蛋白(hs-CRP)水平;流式细胞术检测T淋巴细胞亚群水平;免疫透射比浊法检测LPO、MDA、SS水平,对比两组患者治疗效果、溃疡愈合情况及不良反应发生情况.结果 治疗后联合治疗组患者H+-K+-ATP酶活性低于法莫替丁组[(2.54±0.41) μmol/min比(2.87±0.50)μmol/min],胃内酸碱值高于法莫替丁组(5.56±1.19比4.77±0.89),差异均有统计学意义(P＜0.05).治疗后联合治疗组患者五肽胃泌素刺激后的最大胃酸排出量(MAO)和高峰胃酸排出量(PAO)、基础胃酸排出量(BAO)、TNF-α、IL-17、hs-CRP、CD8+、LPO、MDA水平均低于法莫替丁组[(8.22±1.76) mmol/h比(10.53±2.21) mmol/h、(11.88±2.51) mmol/h比(14.79±2.76) mmol/h、(4.11±1.32) mmol/h比(5.54±1.49) mmol/h、(4.76±1.52) ng/L比(6.91±1.61) ng/L、(18.37±3.25)ng/L比(22.83±3.62) ng/L、(6.41±1.81)mg/L比(8.67±2.15) mg/L、0.287 6±0.030 5比0.325 5±0.032 4、(0.06±0.02) U/mg比(0.09±0.03) U/mg、(10.19±1.86) μmol/L比(13.25±2.03) μmol/L],CD3+、CD4+、SS水平高于法莫替丁组[0.523 6±0.040 9比0.476 3±0.039 5、0.356 6±0.035 2比0.315 8±0.033 9、(14.59±2.67) ng/L比(10.36±2.31) ng/L] (P＜ 0.05).联合治疗组患者治疗总有效率、溃疡愈合率均高于法莫替丁组[93.33％ (70/75)比80.00％ (60/75)、94.67％ (71/75)比82.67％ (62/75)] (P＜0.05).联合治疗组患者不良反应发生率略高于法莫替丁组[16.00％(12/75)比13.33％(10/75)],但两组比较差异无统计学意义(P＞0.05).结论 使用枸橼酸铋钾联合法莫替丁对消化性溃疡患者进行治疗,能够改善患者胃酸分泌功能,调控胃内酸碱值,抑制炎性反应,提升患者免疫功能,减轻氧化应激损伤.“,”Objective To explore the therapeutic effect of bismuth potassium citrate combined with famotidine on peptic ulcer and its effects on the levels of lipid peroxide (LPO),malondialdehyde (MDA) and somatostatin (SS).Methods One hundred and fifty patients with peptic ulcer who were treated in Cixi Cilin Hospital from January 2018 to May 2019 were randomly divided into famotidine group and combined treatment group,with 75 cases in each group.Famotidine group was treated with famotidine,while bismuth potassium citrate combined with famotidine was used in combined treatment group.H+-K+-ATP ase activity,gastric acid-base value and gastric acid secretion function were detected in two groups.The levels of tumor necrosis factor-ot (TNF-α),interleukin-7 (IL-7),hypersensitive C-reactive protein (hs-CRP) were detected by ELISA,T lymphocyte subsets were detected by flow cytometry,and the levels of T lymphocyte subsets were detected by immunotransmission turbidimetry.The levels of LPO,MDA and SS were measured,and the therapeutic effect,ulcer healing and adverse reactions were compared between two groups.Results After treatment,the activity of H+-K+-ATP ase in the combined treatment group was lower than that in the famotidine group [(2.54 ± 0.41) μmol/min vs.(2.87 ± 0.50) μmol/min],the acid-base value in stomach was higher than that in the famotidine group (5.56 ± 1.19 vs.4.77 ± 0.89),and there were significant differences (P ＜ 0.05).After treatment,the levels of maximum gastric acid excretion after pentagastrin stimulation (MAO),peak gastric acid output (PAO),basal acid output (BAO),TNF-α,IL-17,hs-CRP,CD8+,LPO and MDA in combined treatment group were lower than those in famotidine group [(8.22 ± 1.76) mmol/h vs.(10.53 ± 2.21) mmol/h,(11.88 ± 2.51)mmol/h vs.(14.79 ± 2.76) mmol/h,(4.11 ± 1.32) mmol/h vs.(5.54 ± 1.49) mmol/h,(4.76 ± 1.52) ng/L vs.(6.91 ± 1.61) ng/L,(18.37 ± 3.25) ng/L vs.(22.83 ± 3.62) ng/L,(6.41 ± 1.81) mg/L vs.(8.67 ± 2.15) mg/L,0.287 6 ± 0.030 5 vs.0.325 5 ± 0.032 4,(0.06 ± 0.02) U/mg vs.(0.09 ± 0.03) U/mg,(10.19 ± 1.86) μmol/L vs.(13.25 ± 2.03) μmol/L],while the levels of CD3+,CD4+,SS were higher than those in the famotidine group [0.523 6 ± 0.040 9 vs.0.476 3 ± 0.039 5,0.356 6 ± 0.035 2 vs.0.315 8 ± 0.033 9,(14.59 ± 2.67)ng/L vs.(10.36 ± 2.31) ng/L],and there were significant differences (P＜0.05).The total effective rate and ulcer healing rate in combined treatment group were higher than those in famotidine group [93.33％ (70/75) vs.80.00％ (60/75),94.67％ (71/75) vs.82.67％ (62/75)] (P＜ 0.05).The incidence of adverse reactions in combined treatment group was slightly higher than that in famotidine group [16.00％(12/75)vs.13.33％ (10/75)],but there was no significant difference between the two groups (P＞0.05).Conclusions Bismuth potassium citrate combined with famotidine in the treatment of peptic ulcer patients can improve gastric acid secretion function,regulate gastric acid-base value,inhibit inflammatory response,improve immune function,and reduce oxidative stress injury.