根除幽门螺杆菌治疗功能性消化不良的临床观察

Clinical study on the efficacy of helicobacter pylori eradication treatment in patients with functional dyspepsia

目的观察根除幽门螺杆菌(HP)治疗功能性消化不良(FD)患者消化不良症状的疗效。方法HP阳性的FD患者80例随机分为治疗组和对照组。治疗组给予抗HP三联(奥美拉唑、阿莫西林、克拉霉素)治疗1周,同时给予心理支持治疗;对照组患者给予奥美拉唑或促动力药,根据症状缓解或复发情况用药,亦同时给予心理支持治疗。治疗组停药后4周复查HP。治疗前对所有患者的症状进行评分,并比较治疗前及随访1年后的症状评分。结果治疗组40例HP根除者34例(85.0%),HP根除者治疗前与治疗后1年消化道症状评分比较差异有统计学意义(P<0.05);HP未根除者治疗前与治疗后1年的症状评分比较差异无统计学意义(P>0.05);而HP根除者与对照组治疗后1年症状评分比较差异无统计学意义(P>0.05)。结论根除HP能明显改善FD的症状,且治疗费用较持续或间断服用PPI或促动力药明显降低,但却能取得同样的疗效。

Objective To observe efficacy of helicobacter pylori eradication treatment in patients with functional dyspepsia （FD）. Methods Eighty FD patients with HP infection were randomly allocated into two groups：the treatment group were treated with anti-Hp triple therapy （ omeprazole, anxil and clari thronycin ） for one week and given psychological supportive treatment at the same time while those in the control group were treated with omeprazole or promotility drugs according to condition of symptomatic relief or recidivation, and psychological supportive treatment was also supplied. The status of HP infection were determined after four weeks drug withdrawal in treatment group. Symptom scores in the groups were compared between before the treatment and 1 year after the treatment. Results The rate of HP eradication was 85. 0% in the treatment group. The symptom score in patients of pretherapy in the treatment group was significantly different from that one year after the eradication therapy （ P 〈 0. 05 ） ;The symptom score in patients in the treatment group who failed HP eradication had no statislic difference between before the treatment and one year after the treatment （P 〉 0. 05） ;The symptom score in the treatment group after the eradication therapy was not significantly different from that in the control group （ P 〉 0. 05 ）. Conclusion The symptoms of HP-positive FD patients can be obviously improved after treatment by HP eradication. The therapy can lower the medical burden and at the same time achieve the same therapeutic effect.