伏诺拉生联合四联疗法治疗幽门螺杆菌阳性合并慢性萎缩性胃炎效果及对胃肠激素的影响

Effectiveness of Vonoprazan Combined with Quadruple Therapy in the Treatment of Helicobacter Pylori-positive Combined with Chronic Atrophic Gastritis and Its Effect on Gastrointestinal Hormones

目的:探究伏诺拉生联合四联疗法治疗幽门螺杆菌(Hp)阳性合并慢性萎缩性胃炎(CAG)效果。方法:选取2020年9月—2022年9月在福建医科大学附属三明第一医院诊治的Hp阳性合并CAG患者80例,应用随机数字表法将其分为对照组(四联疗法)及观察组(伏诺拉生联合四联疗法),各40例,对比两组治疗有效率、炎症因子[白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、病损面积、胃蛋白酶原(PGⅠ、PGⅡ)、胃肠激素[内皮素(ET)、表皮生长因子(EGF)、降钙素基因相关肽(CGRP)]、胃黏膜环氧化酶-2(COX-2)、超氧化物歧化酶(SOD)、丙二醛(MDA)、不良反应发生率。结果:对照组和观察组治疗有效率相较差异无统计学意义(P>0.05)。治疗前,两组炎症因子差异均无统计学意义(P>0.05);治疗后,两组IL-4、TNF-α、hs-CRP均降低,对照组均高于观察组,差异均有统计学意义(P<0.05)。治疗前,两组病损面积、PGⅠ、PGⅡ差异均无统计学意义(P>0.05);治疗后,两组病损面积均减小、PGⅠ均升高、PGⅡ均无变化,观察组病损面积、PGⅠ改善均优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组胃肠激素水平差异均无统计学意义(P>0.05);治疗后,两组ET、EGF均降低、CGRP均升高,观察组改善均优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组COX-2、SOD、MDA差异均无统计学意义(P>0.05);治疗后,两组COX-2、MDA均降低、SOD均升高,观察组均优于对照组,差异均有统计学意义(P<0.05)。结论:采用伏诺拉生联合四联疗法治疗Hp阳性合并CAG,效果显著,可降低炎症因子,缩小病损面积,下调COX-2、MDA,升高SOD,改善胃肠功能。

Objective:To investigate the effect of Vonoprazan combined with quadruple therapy in the treatment of Helicobacter pylori(Hp)-positive combined with chronic atrophic gastritis(CAG).Method:A total of 80 patients with Hp-positive combined with CAG diagnosed and treated in the First Affiliated Sanming Hospital of Fujian Medical University from September 2020 to September 2022 were selected,and they were divided into the control group(quadruple therapy)and the observation group(Vonoprazan combined with quadruple therapy)by applying the method of randomized number table,with 40 cases in each group.The two groups were compared with each other in terms of treatment effective rate,inflammatory factors[interleukin-4(IL-4),tumor necrosis factor-α(TNF-α),hypersensitive C reactive protein(hs-CRP)],lesion area,pepsinogen(PGⅠ,PGⅡ),gastrointestinal hormones[endothelin(ET),epidermal growth factor(EGF),calcitonin gene-related peptide(CGRP)],gastric mucosal cyclooxygenase-2(COX-2),superoxide dismutase(SOD),malondialdehyde(MDA)and the incidence of adverse reactions.Result:The difference in treatment efficiency between the control group and the observation group was not significant(P>0.05).Before treatment,the differences of inflammatory factors between the two groups were not significant(P>0.05);after treatment,IL-4,TNF-α,hs-CRP were reduced in both groups,and those of the control group were higher than those of the observation group,with statistically significant differences(P<0.05).Before treatment,the differences in lesion area,PGⅠand PGⅡbetween the two groups were not significant(P>0.05);after treatment,the lesion area of the two groups decreased,PGⅠincreased,PGⅡremained unchanged in both groups,and the improvement of the lesion area and PGⅠin the observation group were better than those in the control group,the differences were statistically significant(P<0.05).Before treatment,the differences in gastrointestinal hormone levels between the two groups were not significant(P>0.05);after treatment,ET and EGF decreased and CGRP increased in both groups,and the improvement in the observation group were better than those in the control group,with statistical significance(P<0.05).Before treatment,the differences of COX-2,SOD and MDA between the two groups were not significant(P>0.05);after treatment,COX-2,MDA decreased and SOD increased in the two groups,and those of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Vonoprazan combined with quadruple therapy in the treatment of Hp-positive combined with CAG has a significant effect,reducing inflammatory factors,reducing lesion area,downregulating COX-2 and MDA,increasing SOD,and improving gastrointestinal function.