艾普拉唑四联疗法初次治疗及补救治疗幽门螺杆菌感染慢性胃炎效果评估

Evaluation of the Efficacy of Initial Treatment and Remedial Treatment of Helicobacter Pylori Infection in Chronic Gastritis with Eprazole Quadruple Therapy

目的:评估艾普拉唑四联疗法初次治疗及补救治疗幽门螺杆菌感染慢性胃炎的效果。方法:选取笔者所在医院2017年3月-2019年2月收治的126例Hp慢性胃炎患者,根据是否具有Hp根除治疗史,分为补救组(n=42)与初治组(n=84),初治组随机分为A组与B组,每组42例。补救组以艾普拉唑、枸橼酸铋钾、四环素及庆大霉素联合治疗,A组以埃索美拉唑、枸橼酸铋钾、阿莫西林克拉维酸钾及左氧氟沙星治疗,B组以艾普拉唑、枸橼酸铋钾、阿莫西林克拉维酸钾及左氧氟沙星治疗。对三组临床疗效做出分析。结果:B组临床总有效率为92.86%,高于A组的76.19%,差异有统计学意义(P<0.05);B组Hp根除率为85.71%,高于A组的66.67%,差异有统计学意义(P<0.05);补救组治疗后上腹部疼痛、烧灼感及反酸等症状评分均低于治疗前,差异均有统计学意义(P<0.05);B组不良反应发生率为9.52%,低于A组的28.57%,差异有统计学意义(P<0.05),与补救组的14.29%比较,差异无统计学意义(P>0.05)。结论:艾普拉唑四联疗法在Hp慢性胃炎首次治疗的疗效确切,安全性高;作为既往治疗失败的补救治疗措施,可进一步改善患者临床症状,提升疗效,值得推广应用。

Objective:To evaluate the efficacy of Eprazole quadruple therapy in the initial treatment and remedial treatment of chronic gastritis with Helicobacter pylori(Hp)infection.Method:A total of 126 patients with Hp chronic gastritis admitted to the author’s hospital from March 2017 to February 2019 were selected.All patients were divided into the remedial group(n=42)and the initial treatment group(n=84)according to the previous Hp eradication treatment.All patients in the initial treatment group were divided into group A and group B according to the random number table method,with 42 cases in each group.The remedial group was treated with combination of Eprazole,Bismuth Potassium Citrate,Tetracycline and Gendamycin,the group A was treated with Esomeprazole,Bismuth Potassium Citrate,Amoxicillin clavulanate and Levofloxacin,the group B was treated with Eprazole,Bismuth Potassium Citrate,Amoxicillin clavulanate and Levofloxacin.The clinical efficacy of 3 groups was analyzed.Result:The total clinical effective rate in group B was 92.86%,higher than 76.19%in group A,the difference was statistically significant(P<0.05).The eradication rate of Hp pylori in group B was 85.71%,higher than 66.67%in group A,the difference was statistically significant(P<0.05).After treatment,the symptom scores of epigastric pain,burning sensation and acid reflux in the remedial group were lower than those before treatment,the differences were statistically significant(P<0.05).The incidence of adverse reactions in group B was 9.52%,lower than 28.57%in group A,the difference was statistically significant(P<0.05),and there was no statistically significant difference compared with 14.29%in the remedial group(P>0.05).Conclusion:Eprazole quadruple therapy is exact curative effect in the first treatment of Hp chronic gastritis,high safety,as a remedial treatment measure for previous treatment failure,it can further improve the clinical symptoms of patients,improve the curative effect,it is worth popularizing and applying.