埃索美拉唑与奥美拉唑治疗幽门螺杆菌相关性胃溃疡的临床疗效对比

Clinical Efficacy Comparison of Esomeprazole and Omeprazole in the Treatment of Helicobacter Pylori Associated with Gastric Ulcer

目的比较埃索美拉唑和奥美拉唑治疗幽门螺杆菌相关性胃溃疡的临床疗效。方法选取2012年11月至2014年12月经医院消化内科确诊为胃溃疡且幽门螺杆菌为阳性的患者84例,按入院先后顺序均分为试验组和对照组,每组42例。治疗前2周予以试验组患者以埃索美拉唑为主的幽门螺杆菌根除三联方案,2周后只给予埃索美拉唑继续治疗6周;治疗前2周予以对照组的患者以奥美拉唑为主的幽门螺杆菌根除三联方案,2周后只给予奥美拉唑继续治疗6周。对比两组患者的溃疡愈合总有效率、夜间酸突破发生率、幽门螺杆菌根除率及治疗前后的症状总积分。结果试验组总有效率为92.85%,高于对照组的71.43%(χ2=6.574,P<0.05);治疗2周后,两组患者的症状总积分均明显下降,试验组治疗2周时为(2.59±1.25)分、治疗8周时为(1.11±0.79)分,均显著低于对照组的(3.49±1.42)分和(2.46±1.47)分,差异有统计学意义(t=3.083,5.243,P<0.05)。结论埃索美拉唑治疗幽门螺杆菌相关性胃溃疡,疗效更显著,恢复情况较好,溃疡愈合率较高,值得临床推广。

Objective To compare the clinical efficacy of esomeprazole and omeprazole in the treatment of gastric ulcer associated with Helicobacter pylori. Methods 84 cases of patients diagnosed as gastric ulcer associated with Helicobacter pylori from November 2012 to December 2014 divided into the experimental group and the control group according to the admission sequence, 42 cases in each group. 2 weeks prior to treatment, the experimental group received esomeprazole based triple therapy for Helicobacter pylori eradication, then esomeprazole only was given after 2 weeks and continued for 6 weeks of treatment; 2 weeks prior to treatment, the control group received omeprazole based triple therapy for Helicobacter pylori eradication, then omeprazole only was given after 2 weeks and continued for 6 weeks of treatment. The total effective rate of ulcer healing, the incidence of acid breakthrough at night, Helicobacter pylori eradi- cation rate and total score of symptoms before and after treatment in the two groups were compared. Results The total effective rate in the experimental group was significantly higher than the control group with statistically difference（X2=6. 574, P 〈 0. 05）; after 2 weeks of treatment, scores in the two groups were significantly decreased, the total symptom score in the experiment group after 2 weeks was （2. 59 ± 1.25）, （1.11 ±0.79） after 8 weeks, which were significantly lower than（3.49± 1.42） and（2.46 ± 1.47） of the control group （t = 3. 083, 5. 243, P 〈 0. 05）. Conclusion Esomeprazole in treating the Helicobacter pylori associated gastric ulcer has obvious effi- cacy and good recovery, the ulcer healing rate is higher, which is worthy of clinical promotion.