瑞巴派特联合三联疗法在幽门螺杆菌阳性胃十二指肠溃疡急性穿孔保守治疗中的应用研究  

Application of Rebamipide Combined with Triple Therapy in Conservative Treatment of Acute Perforation of Helicobacter Pylori-Positive Gastroduodenal Ulcer

作　　者：张文利[1] 丁顺斌[1] 董家琪 邓宏[1] 宋雄峰 周贤 ZHANG Wenli;DING Shunbin;DONG Jiaqi;DENG Hong;SONG Xiongfeng;ZHOU Xian(Dept. of Gastroenterology, Deyang People’s Hospital, Sichuan Deyang 618000, China;Dept. of Gastroenterology, Affiliated Hospital of Southwest Medical University, Sichuan Luzhou 646000, China)

机构地区：[1]德阳市人民医院消化内科,四川德阳618000 [2]西南医科大学附属医院消化内科,四川泸州646000

出　　处：《中国医院用药评价与分析》2020年第8期928-931,935,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：四川省卫生计生委科研课题(No.17PJ114)。

摘　　要：目的:探讨瑞巴派特联合三联疗法在幽门螺杆菌(Helicobacter pylori,Hp)阳性胃十二指肠溃疡急性穿孔保守治疗中的应用。方法:选取2015年10月至2019年12月德阳市人民医院收治住院的Hp阳性胃十二指肠溃疡急性穿孔患者105例,采用随机数字表法将患者分为研究组(n=55)和对照组(n=50)。两组患者均进行保守治疗,对照组患者在此基础上采用三联疗法,研究组患者在对照组的基础上给予瑞巴派特治疗。观察两组患者的临床疗效、住院情况、Hp根除情况及溃疡愈合情况,治疗前后血清炎症因子[肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)]和胃肠激素[胃泌素(Gas)、胃蛋白酶原Ⅰ(PGⅠ)和胃蛋白酶原Ⅱ(PGⅡ)]水平,记录并比较研究期间两组患者不良反应发生情况的差异。结果:研究组患者的总有效率为94.55%(52/55),明显高于对照组的82.00%(41/50),差异有统计学意义(P<0.05)。研究组患者临床症状缓解时间、胃肠减压时间和住院时间明显短于对照组,差异均有统计学意义(P<0.05)。研究组患者的Hp根除率为90.91%(50/55),明显高于对照组的76.00%(38/50);研究组患者溃疡愈合率为87.27%(48/55),明显高于对照组的68.00%(34/50),差异均有统计学意义(P<0.05)。治疗后,两组患者血清TNF-α和IL-6水平明显低于治疗前,且研究组患者明显低于对照组;治疗后,两组患者Gas、PGⅠ和PGⅡ水平明显高于治疗前,且研究组患者明显高于对照组,差异均有统计学意义(P<0.05)。研究组、对照组患者不良反应发生率分别为9.09%(5/55)、12.00%(6/50),差异无统计学意义(P>0.05)。结论:瑞巴派特联合三联疗法可有效减轻进行保守治疗的Hp阳性胃十二指肠溃疡急性穿孔患者的炎症反应,改善胃肠功能,促进溃疡面愈合,提高Hp根除率,缩短临床症状缓解时间、胃肠减压时间和住院时间,疗效确切,具有一定的临床应用价值。OBJECTIVE:To probe into the application of rebamipide combined with triple therapy in conservative treatment of acute perforation of gastroduodenal ulcer with positive Helicobacter pylori(Hp).METHODS:105 patients with acute perforation of Hp-positive gastroduodenal ulcer admitted into Deyang People’s Hospita from Oct.2015 to Dec.2019 were selected and divided into research group(55 cases)and control group(50 cases)via random number table.Both groups were given conservative treatment,the control group was given triple therapy on that basis,while the research group was treated with ribapamide based on the control group.The clinical efficacy,hospitalization,HP eradication,ulcer healing,serum inflammatory factors[tumor necrosis factorα(TNF-α),interleukin-6(IL-6)]and gastrointestinal hormones[gastrin(Gas),pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ)]levels before and after treatment of both groups were observed,differences in incidences of adverse drug reactions during study were recorded and compared.RESULTS:The total effective rate of research group was 94.55%(52/55),which was significantly higher than that of the control group(82.00%,41/50),with statistically significant difference(P<0.05).The remission time of clinical symptom,gastrointestinal decompression time and hospital stays of research group were significantly shorten than those of the control group,with statistically significant differences(P<0.05).The Hp eradication rate of research group was 90.91%(50/55),which was significantly higher than that of the control group(76.00%,38/50);the ulcer healing rate of research group was 87.27%(48/55),which was significantly higher than that of the control group(68.00%,34/50),with statistically significant differences(P<0.05).After treatment,the serum TNF-αand IL-6 levels of both groups had been significantly decreased,and those of the research group were significantly lower than the control group;after treatment,the Gas,PGⅠand PGⅡlevels of both groups had been significantly increased,and those of the research g

关 键 词：瑞巴派特 三联疗法 胃十二指肠溃疡急性穿孔 幽门螺杆菌 

分 类 号：R975[医药卫生—药品]