埃索美拉唑与奥美拉唑治疗幽门螺杆菌相关性胃溃疡的疗效比较

Comparison of efficacies between esomeprazole and omeprazole in treatment of helicobacter pylori associated gastric ulcer

目的比较埃索美拉唑和奥美拉唑治疗幽门螺杆菌（H．pylori）相关性胃溃疡的疗效。方法我院消化内科门诊初诊的胃溃疡并且H．pylori阳性患者178例，按随机数字表法分为观察组与对照组，分别采用埃索美拉唑四联疗法及奥美拉唑四联疗法治疗，疗程为1周。第2—4周观察组和对照组患者除口服枸橼酸铋钾外分别口服埃索美拉唑镁片或奥美拉唑肠溶片。比较两组患者胃肠道症状的改善情况、不良反应发生情况、H．pylori根除情况、临床疗效。结果①治疗后两组患者胃肠道症状均显著改善（P〈0．05）；观察组腹痛和胃灼热发生率显著低于对照组（P〈0．05），但腹胀和嗳气发生率差异均无统计学意义（P〉0．05）；（多治疗后观察组患者总有效率为89．89％，显著高于对照组（P〈0．05）；（D治疗4周观察组患者H．pylori的根除率为96．63％，显著高于对照组（P〈0．05）；④两组患者均未出现严重不良反应。结论应用埃索美拉唑为主的四联疗法治疗H．pylori相关性胃溃疡在临床疗效及H．pylori根除方面均优于奥美拉唑，并且与奥美拉唑安全性相当，值得临床推荐。

Objective To compare the efficacies between esomeprazole and omeprazole in treatment of Helicobacter pylori （Hp） associated gastric ulcer. Methods One hundred seventy-eight patients who were first visited our department and diagnosed as gastric ulcer and Helicobacter pylori （ H. pyloy） positive were randomly divided into observation and control groups. The two groups were treated with esomeprazole and omeprazole quadruple therapy, respectively. The treatment last for 1 week. On the 2nd -4thweeks,patients in the two groups took esomeprazole and omeprazole, respectively. After 4 weeks treatment, improvement of gastrointestinal symptoms, adverse reactions and H pyloy eradication situation were compared between the two groups. Results （①）Afier the treatment, the inci- dence of gastrointestinal symptoms were significantly reduced in the both groups （P 〈 0. 05 ）. The incidence of abdominal pain and heat-burn was significantly lower in the observation group than that in the control group while no significant differences was found in the incidence of bloating and belching between the two groups. （②）The total effectiveness in the observation group was 89. 89% which was significantly higher than that in the control group （ P 〈 0. 05 ）. ③The H. pylori eradication rate was 96. 63% in the observation group which was significantly higher than that in the control group （ P 〈 0.05 ）. ④No serious adverse reactions were found in the two groups. Conclusion The clinical efficacy and Hp eradication of esomeprazole based on quadruple therapy for Helicobacter pylori associated gastric ulcer were superior to omeprazole. Moreover,it has the same safety as omeprazole. Therefore,it＇s worthy of recommendation.