根除幽门螺杆菌对糖尿病胃轻瘫的治疗作用研究

Therapeutic Effect of Helicobacter Pylori Eradication on Diabetic Gastroparesis

目的观察根除幽门螺杆菌对糖尿病胃轻瘫(DGP)的治疗作用。方法选择2008年3月2010年1月100例幽门螺杆菌阳性DGP患者。随机分为A、B两组。A组给予莫沙比利5mg,3次/d,4周,及根除幽门螺杆菌治疗(埃索美拉唑20mg+克拉霉素500mg+阿莫西林1.0g,12次/d)2周。B组采用莫沙比利5mg,3次/d,4周。记录患者治疗前、治疗4周及停药4周时的症状积分。结果 92例完成实验。A组症状积分治疗4周后明显下降(P<0.01),与停药4周后相比差异无统计学意义(P>0.05),二者均明显低于B组同期(P<0.05、<0.01)。B组症状积分治疗4周后明显下降(P<0.01),停药4周后明显高于治疗4周后(P<0.05),但仍低于治疗前(P<0.05)。A组治疗4周及停药4周后显效率及总有效率分别为57.4%及91.5%、40.4%及83%,明显高于B组35.6%及75.6%、15.6%及53.3%(P<0.05)。结论对幽门螺杆菌阳性的DGP患者根除幽门螺杆菌可明显提高疗效,并有效防止停药后症状复发。

Objective To explore the therapeutic effect of helicobacter pylori（H.pylori） eradication on diabetic gastroparesis（DGP） patients.Methods A total of 100 DGP patients with H.pylori infection diagnosed between March 2008 and January 2010 were included and randomly divided into two groups.The patients in group A underwent the treatment with mosapride 5 mg（thrice per day） for four weeks and H.pylori eradication therapy（esomeprazole 20 mg,twice per day;clarithromycin 500 mg,twice per day;amoxicillin 1.0 g,twice per day for two weeks）.The patients in group B was administered with mosapride 5 mg（thrice per day） for four weeks.The symptom scores（SS） were recorded pretreatment,4 weeks later and 4 weeks after stopping treatment.Results Ninety-two patients finished the study.The SS in group A decreased significantly（P〈0.01） 4 weeks after the treatment and didn’t differ much from that 4 weeks after stopping the treatment.Both of the SS were lower than those in group B at the same time.In group B,compared with that before the treatment,the SS were much lower than that 4 weeks after the treatment（P〈0.01） and 4 weeks after stopping the treatment（P〈0.05）;the former was significantly lower than the latter（P〈0.05）.The marked efficacy rate and total efficacy rate in group A were higher than those in group B（4-week treatment： 57.4% and 91.5% vs.35.6% and 75.6%,4 weeks after stopping the treatment： 40.4% and 83% vs.15.6% and 53.3%）（P〈0.05）.Conclusion H.pylori eradication can increase the therapeutic effect on H.pylori positive patients with DGP and reduce the recurrence of the symptoms remarkably.