果胶铋联合阿莫西林治疗慢性萎缩性胃炎患者的临床研究

Clinical trial of bismuth pectin combined with amoxicillin in the treatment of patients with chronic atrophic gastritis

目的观察果胶铋联合阿莫西林治疗慢性萎缩性胃炎(CAG)对患者胃蛋白酶原比值(PGR)和幽门螺杆菌(Hp)转阴率的影响。方法将90例CAG患者,随机分为试验组45例和对照组45例。对照组给予阿莫西林胶囊,每次0.5 g,每天2次,口服。试验组在对照组的基础上给予胶体果胶铋胶囊,每次150 mg,每天3次,口服。2组患者均持续治疗4周。比较2组患者的血清胃泌素-17(G-17)、PGR、Hp转阴率、炎症因子和用药安全性。结果治疗后,对照组和试验组G-17水平分别为(362.23±50.10),(391.17±61.11)ng·L-1,PGR水平分别为(25.62±2.87),(29.44±5.18),胃黏膜炎症评分分别为(1.92±0.62),(1.37±0.52)分,炎症活动度评分分别为(2.04±0.56),(1.43±0.49)分,腺体萎缩评分分别为(1.87±0.40),(1.36±0.46)分,白细胞介素-6(IL-6)水平分别为(42.09±4.24),(38.01±3.49)ng·mL-1,白细胞介素-1β(IL-1β)水平分别为(22.46±3.66),(15.78±2.57)ng·mL-1,一氧化氮合酶2(NOS2)水平分别为(85.49±10.19),(71.18±9.64)ng·mL-1,差异均有统计学意义(均P<0.05)。试验组Hp阴性为39例,转阴率为86.67%。对照组Hp阴性为31例,转阴率为68.89%,组间比较差异有统计学意义(P<0.05)。对照组和试验组的药物不良反应发生率分别为4.44%(2例/45例),8.89%(4例/45例),差异无统计学意义(P>0.05)。结论果胶铋联合阿莫西林治疗CAG效果确切,能显著降低炎症因子水平,促进Hp转阴,改善胃黏膜分泌能力,减轻胃黏膜损伤,安全性高。

Objective To explore the effect of bismuth pectin combined with amoxicillin on the negative conversion rate of pepsinogen ratio(PGR) and Helicobacter pylori(Hp) in patients with chronic atrophic gastritis(CAG). Methods Ninety patients with CAG were randomly divided into treatment group(45 cases) and control group(45 cases). Control group was treated with amoxicillin capsule, 500 mg·time-1, twice a day,orally. On the basis of control group, treatment group was treated with colloidal bismuth pectin capsule 150 mg·time-1, 3 times·d-1, orally. Both groups were treated for 4 weeks. The serum gastrin-17(G-17), PGR, Hp negative rate, inflammatory factors and medication safety of the two groups were compared. Results After treatment, the levels of G-17 in control group and treatment group were (362. 23 ± 50. 10),(391. 17 ± 61. 11) ng·L-1,the levels of PGR were 25. 62 ± 2. 87 and 29. 44 ± 5. 18,the scores of gastric mucosal inflammation were 1. 92 ± 0. 62 and 1. 37 ± 0. 52, the scores of inflammation activity were 2. 04 ± 0. 56 and 1. 43 ± 0. 49,the scores of gland atrophy were 1. 87 ± 0. 40 and 1. 36 ± 0. 46,the levels of interleukin-6(IL-6) were(42. 09 ± 4. 24),(38. 01 ± 3. 49) ng · mL-1,the levels of interleukin-1β(IL-1β) were(22. 46 ± 3. 66),(15. 78 ± 2. 57) ng·mL-1,the levels of nitric oxide synthase 2(NOS2) were(85. 49 ± 10. 19),(71. 18 ± 9. 64) ng·mL-1,all with significant differences(all P < 0. 05). There were 39 cases of Hp negative in treatment group,the negative rate was 86. 67%;there were 31 cases of Hp negative in control group,the negative rate was 68. 89%,with significant difference(P < 0. 05). The incidence of adverse drug reactions in control group and treatment group were 4. 44%(2 cases/45 cases) and 8. 89%(4 cases/45 cases),with no significant difference(P > 0. 05). Conclusion Bismuth pectin combined with amoxicillin is effective in the treatment of CAG,can significantly reduce the level of inflammatory factors,promote the negative turn of Hp,improve the secretion of gastric mucosa,reduce the injury of gastric mucosa,and has high safety.