复方元胡铋钾片治疗幽门螺杆菌阳性胃溃疡54例临床观察

Clinical observation on 54 cases of helicobacter pylori-positive gastric ulcer treated with compound Yuanhu bismuth potassium tablets

目的评价复方元胡铋钾片治疗幽门螺杆菌(helicobacter pylori,Hp)阳性胃溃疡的临床疗效和安全性。方法选择于2015年2月至2018年2月在本院消化内科门诊就诊的108例Hp阳性胃溃疡患者,将其采用随机数字表法均分为观察组和对照组,各54例。观察组:含复方元胡铋钾片的四联抗Hp疗法2周后,继续艾司奥美拉唑镁肠溶片+磷酸铝凝胶6周;对照组:含枸橼酸铋钾胶囊的四联疗法2周后,继续艾司奥美拉唑镁肠溶片+磷酸铝凝胶6周。4周后,观察两组患者溃疡直径、数量、溃疡愈合率及症状体征积分,停药后统计不良反应,停药两周后复查14C呼气试验。结果 4周后,与对照组相比,观察组患者的腹痛、腹胀[(3.79±1.06)d对(4.49±1.15)d]及嗳气症状[(6.39±2.17)d对(7.38±2.66)d]的缓解天数明显低于对照组,溃疡直径及数量[(0.42±0.35)个对(0.58±0.44)个]也均明显低于对照组,但是溃疡愈合率(25.93%对11.11%)高于对照组,症状体征积分[(1.25±1.12)对(1.97±1.88)]明显低于对照组,以上差异均有统计学意义(均P <0.05)。观察组Hp根除率(94.44%对81.48%)高于对照组,差异也有统计学意义(P <0.05),但是两组患者不良反应评分差异[(0.13±0.17)对(0.16±0.28)]无统计学意义(P> 0.05)。结论复方元胡铋钾片作为一种铋剂和中药制剂的复合物,治疗Hp阳性胃溃疡效果较好,安全性高,值得临床医生选择。

Objective To evaluete the efficacy of Yuanhu bismuth potassium compound in treatment of patients with helicobacter pylori(Hp)-positive gastric ulcer. Methods One hundred and eight patients with gastric ulcer and Hp infection were admitted to the outpatient clinic from February 2015 to February 2018 were randomly divided into observation group(54 cases) and control group(54 cases). After 2 weeks of quadruple therapy with Yuanhu bismuth potassium compound tablets anti-HP, the esmeprazole magnesium enteric-coated tablets+aluminum phosphate gel were continued for 6 weeks.Control group: after 2 weeks of quadruple therapy containing bismuth potassium citrate capsules, the esomeprazole magnesium enteric-coated tablets and aluminum phosphate gel were continued for 6 weeks. After 4 weeks of treatment, the ulcer diameter, number, ulcer healing rate, symptom and sign scores of the two groups were observed. Adverse reactions, 14 C breath test was reviewed two weeks after stopping the drug. Results After 4 weeks of treatment, compared with the control group, the relief days of abdominal pain, abdominal distension [(3.79±1.06) vs(4.49±1.15)] and belching symptoms[(6.39±2.17) vs(7.38±2.66)] in the observation group were significantly lower than those in the control group, and the diameter and number of ulcers [(0.42±0.35) vs(0.58±0.44)] were also significantly lower than those in the control group, but the ulcer healing rate(25.93% vs 11.11%) was higher than that in the control group, and the symptom and sign integral [(1.25±1.12) vs(1.97±1.88)] was significantly lower than that of the control group, and the above differences had statistical significance(P<0.05). The eradication rate of Hp in the observation group(94.44% vs 81.48%) was higher than that in the control group, and the difference was statistically significant(P<0.05). However, there was no significant difference in the adverse reaction score between the two groups [(0.13±0.17) vs(0.16±0.28), P>0.05)]. Conclusion As a compound of tincture and traditional Chinese medicine preparation, combined Yuanhu bismuth potassium tablet has obvious effects in the treatment of gastric ulcer, and can be widely used as an effective mean in clinical practice.