四联疗法治疗2型糖尿病合并幽门螺杆菌阳性消化性溃疡的临床研究  

Clinical trial of guadruple therapy for type 2 diabetic mellitus patients with Helicobacter pylori positive peptic ulcer

作　　者：陈德清[1] 何松[2] 左的于[3] 邱子津[4] 杜小龙[2] 左国庆[1] CHEN De - qing HE Song ZUO De - yu QIU Zi - jin DU Xiao - long ZUO Guo - qing(The Second Clinical College, Chongqing Medical University, Chongqing 400016 Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010 Department of Internal Medicine Cardiovascular, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 Department of Medical Cosmetology, Chongqing Medicine and Pharmaceutical College, Chongqing 401331, China)

机构地区：[1]重庆医科大学第二临床学院,重庆400016 [2]重庆医科大学附属第二医院消化内科,重庆400010 [3]重庆医科大学附属第一医院心内科,重庆400016 [4]重庆医药高等专科学校医学美容教研室,重庆401331

出　　处：《中国临床药理学杂志》2017年第12期1091-1093,共3页The Chinese Journal of Clinical Pharmacology

基　　金：国家自然科学基金资助项目(81271598);重庆市卫生局医学科研重点基金资助项目(2012-1-035)

摘　　要：目的观察四联疗法治疗2型糖尿病合并幽门螺杆菌阳性消化性溃疡的临床疗效。方法 176例Hp阳性消化性溃疡患者为对照组,122例2型糖尿病合并Hp阳性消化性溃疡患者为试验组。2组患者均予以口服雷贝拉唑10 mg qd+口服克拉霉素0.25 g bid+口服阿莫西林0.5 g bid+口服枸橼酸铋钾0.3 g qid。克拉霉素与阿莫西林只服用前10天,其余药均服用4周。比较2组患者的临床疗效和药物不良反应的发生情况,并分析2型糖尿病与根除Hp的关系。结果治疗后,试验组和对照组的总有效率分别为86.06%(105/122例)和94.32%(166/176例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的Hp根除率分别为72.13%(88/122例)和86.93%(153/176例),差异有统计学意义(P<0.05)。试验组的药物不良反应主要有恶心、腹泻和黑便;对照组的药物不良反应主要有恶心、腹泻和呕吐。试验组和对照组的药物不良反应发生率分别为9.83%(12/122例)和10.23%(18/176例),差异无统计学意义(P<0.05)。结论治疗后,对照组的临床疗效优于试验组,提示临床应该要根据2型糖尿病和Hp阳性消化性溃疡的双重特点综合制定治疗方案,以提高临床疗效。Objective To study the clinical efficacy of quadruple therapy for type 2 diabetic mellitus（DM） patients with Helicobacter pylori（Hp） positive peptic ulcer. Methods A total of 176 patients with Hp-positive peptic ulcer were enrolled in the control group and 122 Hp-positive peptic ulcer patients with type 2 diabetes were involved in the treatment group. Both groups were treated with oral rabeprazole 10 mg qd ＋oral clarithromycin 0. 25 g bid ＋ oral amoxicillin 0. 5 g bid ＋ oral citrate bismuth potassium 0. 3 g qid. Clarithromycin and amoxicillin were used for the first 10 days,the remaining drugs are taking 4 weeks. The clinical efficacy and the incidence of adverse drug reactions between the groups were compared,and the relationship between the type 2 diabetes and the eradication of Hp were analyzed. Results After treatment,the total effective rates of the treatment group and the control group were86. 06%（105/122 cases） and 94. 32%（166/176 cases） respectively,with statistically significant difference（P〈0. 05）. The eradication rates of Hp in the treatment group and the control group were 72. 13%（88/122 cases）and 86. 93%（153/176 cases） respectively,and the difference was statistically significant（P〈0. 05）. Adverse reactions in the treatment group were nausea,diarrhea and melena; adverse effects in the control group were nausea,diarrhea and vomiting. The incidences of adverse drug reactions in the treatment group and the control group were 9. 83%（12/122 cases） and 10. 23%（18/176 cases）,without statistically significant difference（P〉0. 05）. Conclusion The clinical efficacy of the control group was better than that of the treatment group,indicating that type 2 diabetes should be considered as a key factor in the treatment of Hp positive peptic ulcer.

关 键 词：四联疗法 幽门螺杆菌 2型糖尿病 消化性溃疡 

分 类 号：R975[医药卫生—药品]