不同含铋剂四联疗法治疗Hp阳性慢性萎缩性胃炎的效果比较

Therapeutic effects of different bismuth containing quadruple therapies on Hp positive chronic atrophic gastritis

目的探讨不同含铋剂四联疗法在幽门螺杆菌(Hp)阳性慢性萎缩性胃炎治疗中的临床效果。方法抽取2018年5月至2020年5月收治的96例慢性萎缩性胃炎患者为研究对象,根据掷硬币法分为观察组(48例)和对照组(48例)。对照组采用含铋剂四联疗法(左氧氟沙星片、阿莫西林胶囊、雷贝拉唑钠肠溶片、复方铝酸铋片)治疗2个疗程,观察组在对照组疗程基础上延长雷贝拉唑钠肠溶片、复方铝酸铋片服用时间。比较两组血清指标[血清胃泌素、降钙素原(PCT)]、Hp清除率、复发率。结果治疗结束后,观察组总有效率(95.83%,46/48)高于对照组(81.25%,39/48),差异有统计学意义(P<0.05)。治疗结束后,两组胃泌素、PCT水平低于治疗前,且观察组胃泌素、PCT水平低于对照组,差异有统计学意义(P<0.05)。治疗结束后,观察组Hp清除率(95.83%,46/48)高于对照组(81.25%,39/48),差异有统计学意义(P<0.05)。两组复发率比较差异未见统计学意义(P>0.05)。结论含铋剂四联疗法中延长PPI和铋剂疗程,有助于提高慢性萎缩性胃炎的治疗效果,提高Hp清除率,改善胃泌素、PCT水平,且一定程度上可降低复发率。

Objective To investigate the clinical effects of different bismuth containing quadruple therapies in the treatment of Helicobacter pylori(Hp)positive chronic atrophic gastritis.Methods A total of 96 patients with chronic atrophic gastritis treated in Weihai Third Municipal Hospital from May 2018 to May 2020 were selected as the research objects,and they were divided into observation group(48 cases)and control group(48 cases)by tossing coin.The control group was treated with bismuth containing quadruple therapy(levofloxacin tablets,amoxicillin capsules,rabeprazole sodium enteric coated tablets,compound bismuth aluminate tablets)for 2 courses;while the observation group had prolonged admission course of rabeprazole sodium enteric coated tablets and compound bismuth aluminate tablets based on the treatment of the control group.The serum indexes,including serum gastrin and procalcitonin(PCT),Hp clearance rate,and recurrence rate were compared between the two groups.Results After treatment,the total effective rate of the observation group was 95.83%(46/48),higher than 81.25%(39/48)of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of gastrin and PCT in the two groups were lower than before treatment,and the levels of gastrin and PCT in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the Hp clearance rate of the observation group(95.83%,46/48)was higher than that of the control group(81.25%,39/48),and the difference was statistically significant(P<0.05).There was no significant difference in recurrence rate between the two groups(P>0.05).Conclusions Prolonging the course of PPI and bismuth in bismuth containing quadruple therapy is helpful to improve the therapeutic effect of chronic atrophic gastritis,increase the Hp clearance rate,improve the levels of gastrin and PCT,and reduce the recurrence rate to a certain extent.