胶体果胶铋联合泮托拉唑三联治疗H.pylori阳性胃溃疡的疗效分析

Effect of colloidal bismuth pectin combined with pantoprazole-based triple in treatment of H. pylori positive gastric ulcer

目的观察胶体果胶铋联合泮托拉唑三联对H.pylori阳性胃溃疡的溃疡愈合质量的影响以及根除H.pylori的疗效。方法将经胃镜检查及14C呼气试验确诊的90例H.pylori阳性胃溃疡患者随机分为两组:对照组45例,口服泮托拉唑40 mg bid+左氧氟沙星200 mg bid+阿莫西林1 000 mg bid,连续口服10 d后,停服阿莫西林及左氧氟沙星,继续口服泮托拉唑40 mg qd维持3周;试验组45例,在对照组的基础上加用胶体果胶铋干混悬剂150 mg qid。停药4周后复查14C呼气试验,观察H.pylori根除情况;疗程结束后,胃镜复查评估溃疡愈合情况。结果试验组和对照组H.pylori根除率分别为88.89%、71.11%,两组相比,差异有统计学意义(P<0.05);溃疡愈合率分别为86.67%、68.89%,两组相比,差异有统计学意义(P<0.05)。试验组溃疡愈合S2期获得率57.78%,显著高于对照组的33.33%(P<0.05)。结论胶体果胶铋联合泮托拉唑三联治疗H.pylori阳性胃溃疡是一种高效、简便、安全的临床方案,胶体果胶铋在抗H.pylori、提高溃疡愈合质量上起着重要作用。

Objective To observe the ulcer healing and H. pylori eradication efficacy of colloidal bismuth pectin combined with pantoprazole-based triple in treatment of H. pylori positive gastric ulcer. Methods Ninety cases of H. py- lori positive gastric ulcer patients were randomly divided into two groups, the control group （45 patients） were treated with the following 10-day regimens： pantoprazole 40 mg twice a day, levofloxacin 200 mg twice a day, amoxicillin 1 000 mg twice a day, followed by oral pantoprazole 40 mg/d for 3 weeks; the treatment group （45 patients） were added col- loidal bismuth pectin 150 mg four times a day based on the control group. H. pylori eradication rate was reassessed with the ~4C-urea breath test at four weeks after finishing the therapy. Ulcer healing was assessed by gastroscope at the end of treatment. Results H. pylori eradication rate was 88.89% in treatment group and 71.11% in control group, there was significant difference between two groups （P 〈 0.05 ） ; ulcer healing rate of treatment group and control group were 86.67% and 68.89% , respectively, there was statistically significant difference between two groups （P 〈 0.05 ）. The S2 scar ulcer rate （57.78%） was significant higher in treatment group than that in control group （33.33%） （ P 〈 O. 05）. Conclusion Colloidal bismuth pectin combined with pantoprazole-based triple therapy for H. pylori positive gastric ulcer is a simple and safe clinical solution with high efficiency, colloidal bismuth pectin plays an important role in the eradication of H. pylori and improvement of the quality of ulcer healing.