雷贝拉唑与奥美拉唑四联疗法治疗幽门螺杆菌相关性消化性溃疡的疗效比较

Clinical study of omeprazole and rabeprazole quadruple therapy on Helicobacter pylori associated peptic ulcer

目的研究雷贝拉唑与奥美拉唑四联疗法治疗幽门螺杆菌相关性消化性溃疡的疗效比较。方法选取360例幽门螺杆菌相关性消化性溃疡患者,随机数字表法分为两组,雷贝拉唑组患者(180例)给予雷贝拉唑为基础的短效四联疗法,奥美拉唑组患者(180例)给予奥美拉唑为基础的短效四联疗法,均治疗14 d。观察并记录两组患者临床疗效、溃疡愈合率、幽门螺旋杆菌根除率、胃黏膜病理组织学及治疗期间不良反应情况。结果雷贝拉唑组治愈率(81.7%)明显高于奥美拉唑组(68.3%),差异有统计学意义(P<0.05)。治疗前两组上腹部疼痛、上腹部不适及嗳气症状相比,差异无统计学意义。治疗后两组上腹部疼痛、上腹部不适及嗳气患者所占比例降低,同组治疗前后比较差异有统计学意义(P<0.05);且雷贝拉唑组上腹部疼痛、上腹部不适及嗳气患者所占比例低于奥美拉唑组,差异有统计学意义(P<0.05)。治疗后,雷贝拉唑组溃疡愈合率90.6%(163/180),幽门螺杆菌根除率87.8%(158/180),奥美拉唑组溃疡愈合率70.6%(127/180),幽门螺杆菌根除率72.2%(130/180),雷贝拉唑组溃疡愈合率和幽门螺杆菌根除率均高于奥美拉唑组,差异有统计学意义(P<0.05)。治疗前,两组胃黏膜病理组织学评分相比,差异无统计学意义;治疗后,两组胃黏膜病理组织学评分均降低,同组治疗前后比较差异有统计学意义(P<0.05),但组间比较无明显差异。治疗期间,两组不良反应率无明显差异。结论雷贝拉唑短效四联疗法能显著治疗幽门螺旋杆菌引起的消化性溃疡,促进胃黏膜修复,改善消化性溃疡临床症状,用药具有安全性,值得临床推广使用。

Objective To discuss the clinical application value of omeprazole and rabeprazole quadruple therapy on Helicobacter pylori associated peptic ulcer.Methods 360 patients with Helicobacter pylori associated peptic ulcer were selected.They were divided into two groups randomly.The rabeprazole group （180 cases） was treated with rabeprazole with quadruple therapy based,omeprazole group （180 cases） was treated with omeprazole quadruple therapy of short acting as the foundation,to observe and record the two groups of patients with clinical curative effect,the healing rate of ulcer,Helicobacter pylori eradication rate,histopathology and treatment of gastric mucosa during adverse reaction condition.Results The cure rate of rabeprazole group was significantly higher than that of omeprazole group （P 〈 0.05）.Compared the two groups before treatment,upper abdominal pain,abdominal discomfort,belching symptoms,no significant difference,the two groups after treatment in patients with upper abdominal pain,abdominal discomfort and belching percentage of patients decreased,and Rebela was the proportion of patients with lower group （P 〈 0.05）.After treatment,the rabeprazole group of ulcer healing rate 90.5% （163/180）,Helicobacter pylori eradication rate was 87.8% （158/180）,omeprazole group of ulcer healing rate was 70.5% （127/180）,Helicobacter pylori eradication rate was 72.2% （130/180）.The rabeprazole group of the healing rate of ulcer and Helicobacter pylori eradication rate were higher （P 〈 0.05）.Before treatment,there was no significant difference on gastric mucosal histopathological score between two groups.After treatment,two groups of gastric mucosa pathological score were decreased （P 〈 0.05）,no difference between the two groups.During the treatment,there was no significant difference on adverse reactions between two groups.Conclusion Rabeprazole with short acting quadruple therapy can significantly treat Helicobacter pylori causes,promote gastric mucosa repair,improve the clinical symptoms of peptic ulcer,the medication is safe,it is worthy of clinical use.