摘要
目的评价含复方尿囊素四联10 d疗法对H．pylori感染的慢性胃炎患者的疗效，并与含铋剂四联疗法进行比较。方法173例经胃镜证实的H．pylori阳性慢性胃炎患者，分为含尿囊素四联10 d组（43例）、含尿囊素四联24 d组（46例）、含铋剂四联10 d组（42例）和含铋剂四联24 d组（42例）。治疗结束后观察各组患者H．pylori根除率、胃肠道症状（上腹痛、腹胀、嗳气）缓解率和不良反应等。采用意向性分析和符合方案分析，行卡方检验。结果含尿囊素四联10 d组、含尿囊素四联24 d组、含铋剂四联10 d组和含铋剂四联24 d组的H．pylori根除率，行意向性分析分别为90．7％（39／43）、91．3％（42／46）、90．5％（38／42）和88．1％（37／42），行符合方案分析分别为90．7％（39／43）、93．3％（42／45）、90．5％（38／42）和90．2％（37／41），各组比较差异均无统计学意义（P均〉O．05）。治疗后10 d，含尿囊素四联24 d组和含铋剂四联24 d组的上腹痛缓解率分别为81．1％（30／37）和78．8％（26／33），腹胀缓解率分别为82．4％（28／34）和71．0％（22／31），嗳气缓解率分别为76．9％（20／26）和75．0％（21／28），两组比较差异均无统计学意义（P均〉O．05）；治疗后24 d，含尿囊素四联24 d组和含铋剂四联24 d组的上腹痛缓解率分别为91．9％（34／37）和87．9Yoo（29／33），腹胀缓解率分别为94．1％（32／34）和87．1％（27／31），嗳气缓解率分别为96．2％（25／26）和85．7％（24／28），两组比较差异均无统计学意义（P均〉O．05）。两组上腹痛和腹胀缓解率在治疗后24 d比治疗后10 d均有提高，但差异均无统计学意义（P均〉O．05），而含尿囊素四联24 d组的嗳气缓解率在治疗后24 d高于治疗后10 d，差异有统计学意义（x2=4．127，p=0．042）。各组均无严重不良反应发生，含尿囊素四联组无口腔金属异味、舌苔变黑、粪便变黑等不良反应。结论 含复方尿囊素四联10 d疗法作为一线方案治疗H．pylori感染的慢性胃炎，可获得较好的H．pylori根除效果，疗效与含铋剂四联10 d疗法相当，并可获得较高的症状缓解率，无明显不良反应发生。
Objective To evaluate the efficacy of 10-day compound allantoin containing quadrupleregimen in the treatment of chronic gastritis with Helicobacter pylori （H. pylori） infection, and tocompare with the bismuth-containing quadruple therapy. Methods Altogether 173 patients withH. pylori positive chronic gastritis confirmed by gastric endoscope were divided into 10-day compoundallantoin containing quadruple regimen group （n = 43）, 24-day compound allantoin containing quadrupleregimen group （n = 46）, 10-day bismuth-containing quadruple regimen group （n = 42） and 24-daybismuth-containing quadruple regimen group （n = 42）. After the treatment, the eradication rate ofH. pylori, the rate of gastrointestinal symptoms （epigastric pain, bloating and belching） relief and theadverse effects of each group were observed. Intention-to-treat （ITT）, per-protocol （PP） statisticalanalysis and chi-square analysis were performed for statistical analysis. Results H. pylori eradicationrates of 10-day compound allantoin containing quadruple regimen group, 24-day compound allantoin containing quadruple regimen group, 10-day bismuth-containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group analyzed by ITT were 90. 7% （39/43）, 91. 3% （42/46）, 90.5% （38/42） and 88.1%（37/42）, respectively; while analyzed by PP were 90.7% （39/43）, 93.3% （42/45）, 90.5% （38/42） and 90.2% （37/41）, respectively. And there were no statistical differences between groups （all P〉0.05）. Ten days after the treatment, the rates of epigastric pain relief of 24-day compound allantoin containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group were 81.1% （30/37） and 78.8% （26/33）, respectively, the rates of bloating relief were 82.4% （28/34） and 71. 0% （22/31）, respectively, and the rates of belching relief were 76. 9% （20/26） and 75.0% （21/28）, respectively. There were no statistical differences between the two groups fall P〉0.05）. However after 24-day treatment, the rates of epigastric pain relief of 24-day compound allantoin containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group were 91.9 % （34/37） and 87.9% （29/33）, respectively, the rates of bloating relief were 94.1% （32/34） and 87.1% （27/31）, respectively, and the rates of belching relief were 96. 2M （25/26） and 85. 7% （24/28）, respectively. There were no statistical differences between the two groups （all P〉0.05）. And the rates of epigastric pain and bloating relief increased after 24-day treatment compared with those of 10-day treatment, however the differences were not statistically significant between the two groups （all P〉 0.05）. In 24-day compound allantoin containing quadruple regimen group, the rate of belching relief was higher after 24-day treatment compared with that of 10-day treatment, and the difference was statistically significant x2= 4. 127, P= 0. 042）. No severe adverse effects were observed in each group, and there were no adverse effects such as oral metal odor, tongue black and melena in compound allantoin containing quadruple therapy. Conclusions Ten-day compound allantoin containing quadruple therapy as first-line approach in the treatment of chronic gastritis with H. pylori infection can get better H. pylori eradication and the efficacy is similar to bismuth quadruple therapy. Meanwhile the symptom relief rate is high and no obvious adverse effects were found.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2014年第5期297-301,共5页
Chinese Journal of Digestion
关键词
尿囊素
铋
质子泵抑制剂
螺杆菌
幽门
Allantoin
Bismuth
Proton pump inhibitors
Helicobacter pylori
作者简介
通信作者：崔梅花，Email：cuimeih@sina．com
