埃索美拉唑与奥美拉唑为主的三联疗法治疗幽门螺杆菌阳性消化性溃疡临床疗效的比较研究

Comparative study for clinical efficacy of esomeprazole and omeprazole-based triple therapy in the treatment of helicobacter pylori positive peptic ulcer

目的比较埃索美拉唑与奥美拉唑为主的三联疗法治疗幽门螺杆菌(Hp)阳性消化性溃疡(PU的临床疗效。方法选取高州市第二人民医院2015年12月—2018年6月收治的Hp阳性PU患者84例,随机分为对照组与观察组,各42例。两组均予以阿莫西林和克拉霉素治疗,在此基础上对照组予以奥美拉唑治疗,观察组予以埃索美拉唑治疗,两组均治疗4周。比较两组临床疗效、治疗前后T淋巴细胞亚群(包括CD8+细胞分数、CD4+细胞分数)和炎性因子〔包括肿瘤坏死因子α(TNF-α)、白介素8(IL-8)〕、Hp根除率,并观察两组不良反应和复发情况。结果观察组临床疗效优于对照组(P<0.05)。治疗前两组CD8+细胞分数、CD4+细胞分数、TNF-α、IL-8比较,差异无统计学意义(P>0.05);治疗后观察组CD8+细胞分数、CD4+细胞分数高于对照组,TNF-α、IL-8低于对照组(P<0.05)。观察组Hp根除率高于对照组,复发率低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论与奥美拉唑为主的三联疗法相比,埃索美拉唑为主的三联疗法治疗Hp阳性PU的临床疗效确切,可有效减少炎性反应,提高患者免疫功能,降低复发率。

Objective To compare the clinical efficacy of esomeprazole and omeprazole-based triple therapy in the treatment of helicobacter pylori(Hp)positive peptic ulcer(PU).Methods A total of 84 cases of patients with Hp positive PU were selected from December 2015 to June 2018 in the Second People’s Hospital of Gaozhou,which were randomly divided into control group and observation group,42 cases in each group.Both groups were treated with amoxicillin and clarithromycin.On this basis,the control group was treated with omeprazole,while the observation group was treated with esomeprazole.Both groups were treated for 4 weeks.Clinical efficacy,T lymphocyte subsets(CD8+cell fraction,CD4+cell fraction)and inflammatory factors(TNF-α,IL-8)before and after treatment and Hp eradication rate were compared between the two groups,and the occurrence and recurrence of adverse reactions in the two groups were observed.Results The clinical efficacy of the observation group was better than control group(P<0.05).Before treatment,there was no significant difference in CD8+cell fraction,CD4+cell fraction,TNF-α,IL-8 between the two groups(P>0.05);After treatment,the observation group of CD8+cell fraction and CD4+cell fraction were higher than control group,while TNF-αand IL-8 were lower than control group(P<0.05).The observation group of Hp eradication rate higher than control group,and recurrence rate was lower than control group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion Compared with omeprazole-based triple therapy,esomeprazole-based triple therapy have definite clinical efficacy in treating Hp positive PU,it can effectively reduce inflammatory reaction,improve immune function and reduce recurrence rate.