瑞巴派特在Hp阳性胃溃疡患者治疗中的临床疗效分析

Clinical efficacy analysis of rebamipide in the treatment of Helicobacter pylori positive gastric ulcer

目的探讨Hp阳性胃溃疡患者治疗中瑞巴派特的临床疗效和安全性。方法选取2016年1-12月就诊于解放军总医院第六医学中心消化内科并经胃镜诊断为胃溃疡和病理诊断为幽门螺杆菌(Hp)阳性的患者90例。将研究对象按照随机数字表法分为3组:三联组、铋剂四联组、瑞巴派特+三联组,每组各30例。分别比较3组患者在4周后的胃黏膜表皮损伤评分、Hp根除率及腹泻、恶心、呕吐、味觉障碍症状评分情况。结果光镜下黏膜损伤评分3组间差异有统计学意义(P<0.05);两两比较时,瑞巴派特+三联组和铋剂四联组之间差异无统计学意义,而瑞巴派特+三联组和铋剂四联组均低于三联组(P<0.05)。3组之间的Hp根除率差异有统计学意义(P<0.05);两两比较时,铋剂四联组的Hp根除率高于三联组(96.67%vs.73.33%)(P<0.05),瑞巴派特+三联组分别和三联组、铋剂四联组比较,差异均无统计学意义(P>0.05)。3组间的不良反应各分项评分和总评分差异无统计学意义(P>0.05)。结论瑞巴派特治疗Hp阳性的胃溃疡患者时,在黏膜组织形态学改变方面,其效果和铋剂相当,且不良反应轻微,可在根除Hp治疗中发挥一定的作用。

Objective To investigate the clinical efficacy and safety of rebapamide in the treatment of Helicobacter pylori(Hp)positive gastric ulcer.Methods A total of 90 patients with gastric ulcer diagnosed by gastroscopy and Hp positive result diagnosed by pathology were selected from the Department of Gastroenterology of the Sixth Medical Center of PLA General Hospital from January 2016 to December 2016.The patients were randomly divided into three groups:triple group,bismuth quadruple group,and rebamipide+triple group,with 30 cases each.The gastric mucosa epidermal injury score,Hp eradication rate,and symptom scores of diarrhea,nausea,vomiting,and dysgeusia were compared respectively among the three groups after four weeks.Results In terms of mucosal injury score under light microscope,there were statistical differences among the three groups(P<0.05);in post-hoc pairwise comparison,there was no statistical difference between the rebamipide+triplet group and the bismuth quadruple group,while the scores of the rebamipide+triplet group and the bismuth quadruple group were both lower than that of the triplet group(P<0.05).In terms of Hp eradication rate,there were statistical differences among the three groups(P<0.05);in post-hoc pairwise comparison,the Hp eradication rate in the bismuth quadruple group was higher than that in the triplet group(P<0.05);there was no significant difference between the rebamipide+triplet group and the triplet group and the bismuth quadruple group,respectively(P>0.05).In terms of adverse reactions,there was no significant difference in the sub-scores and total scores among the three groups(P>0.05).Conclusion In the treatment of Hp positive gastric ulcer,rebamipide has the same effect as bismuth in terms of mucosal histomorphology changes,and the adverse reactions is slight,which can play a certain role in the eradication of Hp.