不同抗幽门螺杆菌治疗方法对消化性溃疡治疗的临床价值研究  

Clinical Value of Different Anti-Helicobacter Pylori Treatments for Peptic Ulcer

作　　者：林天桥 LIN Tianqiao(Department of Internal Medicine,Xianyou Maternal and Child Health Hospital,Xianyou 351200,China)

机构地区：[1]仙游县妇幼保健院内科,福建仙游351200

出　　处：《中国医药指南》2023年第30期29-32,共4页Guide of China Medicine

摘　　要：目的 探讨不同抗幽门螺杆菌治疗方法对消化性溃疡治疗的临床价值研究。方法 将2021年1月至2022年3月在仙游县妇幼保健院内科治疗的112例幽门螺杆菌(Hp)感染消化性溃疡患者随机分为两组,对照组使用奥美拉唑为主的抗Hp四联疗法,观察组使用雷贝拉唑为主的抗Hp四联疗法,对比两组的临床疗效、Hp清除率、溃疡愈合率、复发率、症状积分变化、胃肠激素、血清因子。结果 对比观察组和对照组的治疗有效率,观察组的治疗有效率高于对照组(P>0.05);对比用药30 d的Hp清除率、溃疡愈合率,观察组均更高,而随访6个月的复发率观察组更低(P<0.05);治疗后腹痛、反酸、上腹饱胀、恶心呕吐等症状积分相比,观察组各项均更低(P<0.05);全身适应综合征(GAS)、胃蛋白酶原Ⅰ(PG-Ⅰ)、胃蛋白酶原Ⅱ(PG-Ⅱ)水平相比,治疗前两组相当(P>0.05),治疗后观察组均低于对照组(P<0.05);治疗后基质金属蛋白酶9(MMP-9)、重组人白细胞介素-1β(IL-1β)、白细胞介素-18(IL-18)、人可溶性血管细胞黏附因子1(sVCAM-1)水平相比,观察组均低于对照组(P<0.05)。结论雷贝拉唑为主的抗Hp四联疗法对消化性溃疡治疗的临床价值更高,能提升Hp根除率,促进溃疡周围炎症减轻,明显缓解整体,提高溃疡愈合率,抑制复发。Objective To investigate the clinical value of different anti-Helicobacter pylori treatment methods in the treatment of peptic ulcer.Methods From January 2021 to March 2022,112 patients with peptic ulcer infected by Helicobacter pylori(Hp)treated in the department of Internal Medicine Xianyou Maternal and Child Health Hospital were randomly divided into two groups.The control group was treated with omeprazole based anti-Hp quadruple therapy,and the observation group was treated with rabeprazole based anti-Hp quadruple therapy.The clinical efficacy,Hp clearance rate,ulcer healing rate,recurrence rate,symptom score change and serum factors were compared between the two groups.Results Comparing the treatment efficiency of the observation group and the control group,the treatment efficiency of the observation group was higher than that of the control group(P>0.05).The Hp clearance rate and ulcer healing rate of 30 days of medication were higher in the observation group,while the recurrence rate of 6 months of follow-up was lower in the observation group(P<0.05).After treatment,the scores of symptoms such as abdominal pain,acid regurgitation,abdominal fullness,nausea and vomiting were lower in the observation group(P<0.05).The levels of GAS,PG-Ⅰand PG-Ⅱin the two groups were similar before treatment(P>0.05),and the levels of GAS,PG-Ⅰand PG-Ⅱin the observation group were lower than those in the control group after treatment(P<0.05).Compared with the levels of MMP-9,IL-1β,IL-18,and sVCAM-1,the observed group were lower than the control group(P<0.05).Conclusions rabeprazole based anti-Hp quadruple therapy has higher clinical value in the treatment of peptic ulcer,which can improve the eradication rate of Hp,promote the reduction of inflammation around the ulcer,significantly alleviate the overall situation,improve the healing rate of ulcer,and inhibit recurrence.

关 键 词：消化性溃疡 抗幽门螺杆菌治疗 奥美拉唑 雷贝拉唑 四联疗法 效果 

分 类 号：R573.1[医药卫生—消化系统]