替普瑞酮联合叶酸治疗Hp阳性消化性胃溃疡的效果  

Effect of Tepredone Combined with Folic Acid on Hp Positive Peptic Ulcer

作　　者：杨璐 杨芳 郭晓鹤[1] 张兰芳[1] 秦蕾[1] 杨艳 YANG Lu;YANG Fang;GUO Xiaohe;ZHANG Lanfang;QIN Lei;YANG Yan(Second Ward of Gastroenterology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院消化内科二病区,河南新乡453000

出　　处：《河南医学研究》2024年第18期3387-3390,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(LHGJ20210539)。

摘　　要：目的观察替普瑞酮联合叶酸治疗幽门螺杆菌(Hp)阳性消化性胃溃疡患者的临床效果。方法选取2022年4月至2023年5月新乡医学院第一附属医院消化内科收治的106例Hp阳性消化性胃溃疡患者为研究对象,并以1∶1比例随机分为对照组、观察组,各53例。两组均接受常规四联疗法治疗。对照组接受叶酸,观察组接受叶酸和替普瑞酮治疗。比较两组临床疗效、Hp清除率、不良反应,治疗前及治疗4周后血清胆囊收缩素(CCK)、胃泌素(GAS)、胃动素(MTL)、胃黏膜形态、白细胞介素-17(IL-17)、C反应蛋白(CRP)、转化生长因子-β1(TGF-β1)、核因子-κB(NF-κB)p65水平。结果观察组临床疗效、Hp清除率高于对照组(P<0.05);治疗4周后两组血清MTL水平上升,且观察组高于对照组,CCK、GAS水平降低,且观察组低于对照组(P<0.05);治疗4周后观察组黏膜厚度、腺体密度、黏膜形态及炎症细胞浸润评分均低于对照组(P<0.05);治疗4周后两组TGF-β1、CRP、NF-κB p65、IL-17表达均有所下降,且观察组低于对照组(P<0.05)。结论替普瑞酮联合叶酸可有效改善Hp阳性消化性胃溃疡患者临床症状,促进胃黏膜及溃疡恢复,增强Hp清除效果,安全性良好。Objective To observe the clinical effect of tipredone combined with folic acid in patients with Hp positive peptic ulcer.Methods A total of 106 patients with Helicobacter pylori(Hp)positive peptic ulcer admitted to Second Ward of Ggastroenterology,the First Affiliated Hospital of Xinxiang Medical University from April 2022 to May 2023 were selected as the study objects,and were randomly divided into control group and observation group with a 1∶1 ratio,with 53 cases in each group.Both groups were treated with conventional quadruple therapy.The control group was given folic acid,and the observation group was given folic acid and tepredone.The clinical efficacy,Hp clearance and adverse reactions of the two groups were compared.Serum levels of cholecystokinin(CCK),gastrin(GAS),motilin(MTL),gastric mucosa morphology,interleukin-17(IL-17),C-reactive protein(CRP),transforming growth factor-β1(TGF-β1),nuclear factor-κB(NF-κB)p65 before and 4 weeks after treatment.Results The clinical efficacy and Hp clearance rate of observation group were higher than those of control group(P<0.05).After 4 weeks of treatment,the serum MTL level of the two groups increased,and the CCK and GAS levels in observation group were higher than those in control group,and the CCK and GAS levels in observation group were lower than those in control group(P<0.05).After 4 weeks of treatment,mucosal thickness,glandular density,mucosal morphology and inflammatory cell infiltration score in observation group were lower than those in control group(P<0.05).After 4 weeks of treatment,the expressions of TGF-β1,CRP,NF-κB p65 and IL-17 in two groups were decreased,and observation group was lower than control group(P<0.05).Conclusion Tipredone combined with folic acid can effectively improve the clinical symptoms of Hp-positive peptic ulcer patients,promote the recovery of gastric mucosa and ulcer,and enhance the clearance effect of Hp,with good safety.

关 键 词：幽门螺杆菌 胃溃疡 替普瑞酮 胃黏膜 

分 类 号：R573.1[医药卫生—消化系统]