含铋剂四联疗法治疗胃溃疡的临床效果观察

Clinical observation of quadruple therapy containing bismuth in the treatment of gastric ulcer

目的探讨含铋剂四联疗法治疗胃溃疡的临床疗效。方法选取2014-01-2015-07因胃溃疡收治的患者63例,随机分为两组。治疗组32例给予以质子抑制剂（PPI）为基础联合二种抗生素加铋剂的四联疗法,对照组31例给予以PPI为基础联合二种抗生素的三联疗法,疗程均为10 d。停药4周后复查14C尿素呼气试验及电子胃镜,观察Hp根除率、胃溃疡愈合情况、临床症状及不良反应情况。结果治疗组治愈9例,有效20例,无效3例;对照组治愈5例,有效16例,无效10例。治疗组疗效优于对照组（Z=2.83,P〈0.05）。治疗组Hp根除率为93.8%,高于对照组的74.2%（P〈0.05）。结论以PPI为基础联合二种抗生素加铋剂的四联疗法对胃溃疡有良好疗效,不良反应发生率低,值得临床借鉴和推广。

Objective To explore the therapeutic effects of quadruple therapy containing bismuth in treatment of gastric ulcer. Methods Sixty-three cases with gastric ulcer were randomly divided into the treatment group( n =32) and the control group( n = 31). The treatment group was treated with quadruple therapy containing PPI,two antibiotics and bismuth. The control group was treated with triple therapy containing PPI and two antibiotics. The course of treatment lasted for 10 days.14C-urea breath test,electronic gastroscope Hp eradication,clinical symptoms and side effects were rechecked 4 weeks after drug withdrawal. Results In the treatment group,9 cases were cured,20 cases effective,3 cases ineffective. In the control group,5 cases were cured,16 cases effective and 10 cases were ineffective. There was significant difference in Hp eradication rate between the treatment group( 93. 8%) and the control group( 74. 2%). Conclusion Quadruple therapy containing bismuth is effective in treatment of gastric ulcer.