不同药物方案治疗幽门螺杆菌阳性慢性胃炎活动期患者的临床疗效及安全性

Influence of different kinds of drug regimens on clinical effects and safety of chronic gastritis with Hp infection for active stage

目的探讨三联药物、四联药物及序贯药物方案治疗幽门螺杆菌(Hp)阳性慢性胃炎活动期患者的临床疗效及安全性。方法选取2015年6月至2017年6月河南省南阳医学高等专科学校第一附属医院收治的Hp阳性慢性胃炎活动期患者180例,采用随机数字表法分为A组、B组及C组3组,每组60例,分别采用三联药物、四联药物及序贯药物方案治疗;比较3组患者疼痛缓解率,症状缓解时间、Hp根除率、不良反应发生率,随访12个月,比较3组患者的复发率。结果 C组疼痛缓解率高于A、B组,疼痛和消化道症状缓解时间短于A、B组,Hp根除率高于A、B组,差异均有统计学意义(P<0.05); C组不良反应发生率低于A、B组,差异有统计学意义(P<0.05); C组随访6个月和12个月复发率均低于A、B组,差异有统计学意义(P<0.05)。结论序贯药物方案治疗Hp阳性慢性胃炎活动期能够有效缓解疼痛,促进症状改善,提高Hp根除率,避免远期复发,并有助于降低不良反应发生风险,优于三联和四联药物方案。

Objective To investigate the influence of triple regimen, quadruple regimen and sequential regimen on clinical effects and safety of chronic gastritis with Hp infection for active stage. Methods A total of 180 patients with chronic gastritis with Hp infection for active stage were chosen in the period from June 2015 to June 2017 in our hospital and randomly divided into three groups, namely group A (60 patients) with triple regimen, group B (60 patients) with quadruple regimen and group C (60 patients) with sequential regimen, and the pain relief rate, symptom relief time, Hp eradication rate, adverse reaction incidence and recurrence rate after follow-up of three groups were compared. Results The pain relief rate of group C was significantly higher than that of group A and group B ( P <0.05). The pain and digestive tract symptom relief time of group C was significantly shorter than that of group A and group B ( P <0.05). The Hp eradication rate of group C was significantly higher than that of group A and group B ( P <0.05). The adverse reaction incidence of group C was significantly lower than that of group A and group B ( P <0.05). The recurrence rate of group C in 6 months and 12 months of follow-up was significantly higher than that of group A and group B ( P <0.05). Conclusion Compared with triple regimen and quadruple regimen, sequential regimen in the treatment of chronic gastritis with Hp infection for active stage can efficiently reduce the pain relief degree, promote the symptom improvement, increase the Hp eradication rate, avoid the long-term recurrence and reduce the risk of adverse reactions.