摘要
目的：比较以奥美拉唑与雷贝拉唑为主两种四联药物方案治疗幽门螺杆菌（Hp）阳性活动性胃溃疡临床效果。方法选取 Hp 阳性活动性胃溃疡患者104例，以随机抽样方法分为 A 组（52例）和 B 组（52例），分别在阿莫西林＋克拉霉素＋胶体果胶铋治疗基础上分别加用奥美拉唑和雷贝拉唑口服治疗；比较两组临床疗效，治疗后7 d、14 d 及28 d 症状缓解率、Hp 根除率，随访复发率及不良反应发生率。结果B 组临床治疗治愈率显著高于 A 组（36．54％比19．23％），差异有统计学意义（χ2＝8．74，P ＜0．05）；两组临床治疗总有效率比较差异无统计学意义（P ＞0．05）；B 组治疗后7 d 和14 d 症状缓解率均显著高于 A 组（96．15％比76．92％，96．15％比78．85％，98．08％比82．69％；98．08％比84．62％，100．00％比82．69％，100．00％比88．46％），差异有统计学意义（χ2＝8．74、7．20、7．91、7．05、6．86、6．33，均 P ＜0．05）；B 组 Hp 清除率显著高于 A 组（92．31％比73．07％），差异有统计学意义（χ2＝9．24，P ＜0．05）；B 组随访复发率显著低于 A组（7．69％比25．00％），差异有统计学意义（χ2＝10．62，P ＜0．05）；同时 B 组不良反应发生率显著低于 A 组（3．85％比13．46％），差异有统计学意义（χ2＝7．85，P ＜0．05）。结论相较于奥美拉唑，以雷贝拉唑为主四联药物方案治疗 Hp 阳性活动性胃溃疡可有效缓解消化道症状，促进溃疡病灶修复，提高 Hp 清除效果，避免远期复发，且有助于降低药物不良反应发生风险。
Objective To compare the clinical effect and safety of two kinds of quadruple therapy on the basis of omeprazole and rabeprazole in the treatment of patients with active gastric ulcer and Hp positive.Methods 104 patients with active gastric ulcer and Hp positive were chosen,and they were randomly divided into two groups including A group （52 patients）with omeprazole treatment,and B group （52 patients）with rabeprazole treatment on the basis of amoxicillin ＋clarithromycin ＋bismuth potassium citrate.The clinical efficacy,clinical symptom remission rate in 7d,14d and 28d after treatment,HP eradication rate,recurrence rate with follow -up and adverse reaction inci-dence of 2 groups were compared.Results The clinical cure rate of B group was significantly higher than A group （36.54% vs.19.23%）（χ2 =8.74,P 〈0.05）.There was no significant difference in the clinical total effective rate between the two groups（P 〈0.05）.The clinical symptom remission rates in 7d and 14d after treatment of B group were significantly higher than A group（96.15% vs.76.92%,96.15% vs.78.85%,98.08% vs.82.69%;98.08%vs.84.62%,100.00% vs.82.69%,100.00% vs.88.46%）（χ2 =8.74,7.20,7.91;7.05,6.86,6.33;all P 〈0.055）.The Hp eradication rate of B group was significantly higher than A group（92.31% vs.73.07%）（χ2 =9.24,P 〈0.05）.The recurrence rate of B group was significantly lower than A group（7.69% vs.25.00%）（χ2 =10.62,P 〈0.05）.The incidence rate of adverse reaction of B group was significantly lower than A group（3.85% vs. 13.46%）（χ2 =7.85,P 〈0.05）.Conclusion Compared with omeprazole,quadruple therapy on the basis of rabe-prazole in the treatment of patients with active gastric ulcer and Hp positive can effectively relieve the digestive symp-toms,promote ulcer repair process,higher the Hp removal effects,prevent the long -term recurrence and is helpful to reduce the adverse drug reactions risk.
出处
《中国基层医药》
CAS
2016年第22期3400-3403,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省丽水市科技计划自筹项目（2014YWZC16）
关键词
质子泵抑制剂
幽门螺杆菌
胃溃疡
Proton pump inhibitor
Helicobacter pylori
Gastric ulcer
