含阿莫西林、呋喃唑酮四联疗法治疗幽门螺杆菌相关性胃溃疡的疗效及安全性分析

Therapeutic effects and safety of quadruple therapy with amoxicillin and furazolidone in treatment of Helicobacter pylori-associated gastric ulcer

目的探讨含阿莫西林、呋喃唑酮四联疗法治疗幽门螺杆菌(H.pylori)相关性胃溃疡的疗效及安全性。方法140例H.pylori相关性胃溃疡患者随机分为对照组和研究组,每组70例。对照组采用兰索拉唑、阿莫西林、呋喃唑酮三联疗法;研究组采用兰索拉唑、阿莫西林、呋喃唑酮、铝碳酸镁四联疗法。2组患者疗程均为6周,比较2组患者临床疗效,消化道综合症状评分,H.pylori清除率,血清胃泌素(GAS)和内皮素(ET)水平以及不良反应。结果2组患者临床疗效以及总有效率差异无统计学意义(P>0.05)。随治疗时间的推移,2组患者消化道综合症状评分均显著下降(P<0.05),研究组消化道综合症状评分下降幅度显著大于对照组(P<0.05),研究组消化道综合症状评分整体水平显著低于对照组(P<0.05)。2组患者H.pylori清除率差异无统计学意义(P>0.05)。2组患者治疗后GAS水平明显升高,组间比较,研究组GAS水平显著高于对照组(P<0.05)。2组治疗后ET水平明显降低,组间相比,研究组ET水平显著低于对照组(P<0.05)。2组患者不良反应发生率差异无统计学意义(P>0.05)。结论铝碳酸镁、兰索拉唑、阿莫西林、呋喃唑酮四联方案治疗H.pylori相关性胃溃疡,具有较好的临床疗效,能够明显缓解和减轻患者的消化道症状,增强胃黏膜防御功能,值得临床推广。

Objective To investigate the therapeutic effects and safety of quadruple therapy with amoxicillin and furazolidone on Helicobacter pylori(H.pylori)-associated gastric ulcer.Methods A total of 140 patients with H.pylori-related gastric ulcer were randomly divided into control group and research group,with 70 cases in each group.The patients in control group were treated by triple therapy,including lansoprazole,amoxicillin and furazolidone,however,the patients in research group were treated by quadruple therapy,including lansoprazole,amoxicillin,furazolidone and hydrotalcite,with a treatment course of 6 weeks for both groups.The clinical efficacy,digestive tract syndrome score,H.pylori clearance rate,serum levels of gastrin(GAS)and endothelin(ET)and the incidence rate of adverse reactions were observed and compared between the two groups.Results There were no significant differences in clinical efficacy and total effective rate between the two groups(P>0.05).Winth the time going on,the digestive tract symptoms scores in both groups were decreased significantly(P<0.05).Moreover the decrease degree of digestive tract syndrome score in research group was more significant than that in control group(P<0.05).The overall scores of digestive tract symptoms in research group were significantly lower than those in control group(P<0.05).There was no significant difference in the clearance rate of H.pylori between the two groups(P>0.05).After treatment,GAS levels in both groups were increased significantly,moreover,the GAS levels in research group were significantly higher than those in control group(P<0.05).The ET levels in both groups were decreased significantly,while the ET levels in research group were significantly lower than those in control group(P<0.05).In addition there was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion The quadruple therapy including lansoprazole,amoxicillin,furazolidone and hydrotalcite in treatment of H.pylori-related gastric ulcer has better clinical efficacy,which can significantly alleviate and the digestive tract symptoms,enhance gastric mucosal defense function of patients,therefor,it is worthy of clinical promotion.