含铋剂的四联疗法治疗消化性溃疡患者的临床疗效及对溃疡愈合、炎症因子的影响

Clinical Efficacy of Bismuth-containing Quadruple Therapy in the Treatment of Patients with Peptic Ulcer and its Effect on Ulcer Healing and Inflammatory Factors

目的研究含铋剂四联疗法治疗消化性溃疡患者的临床疗效及对其溃疡愈合、炎症因子的影响。方法选取2020年5月-2023年5月江西省德兴市人民医院消化内科收治的60例消化性溃疡患者作为研究对象,行随机数字表法分为三联组(30例)和四联组(30例)。三联组采用三联疗法(雷贝拉唑+阿莫西林+克拉霉素),四联组应用含铋剂四联疗法(胶体果胶铋+雷贝拉唑+阿莫西林+克拉霉素),比较两组临床疗效、溃疡愈合情况(溃疡直径、胃黏膜损伤Lanza评分)、炎症因子[白细胞介素2(IL-2)、白细胞介素6(IL-6)]、不良反应、预后情况[消化性溃疡量表(QLICD-PU)、胃溃疡复发率]。结果四联组治疗总有效率为96.67%,高于三联组的80.00%(P<0.05);两组治疗后溃疡直径、胃黏膜损伤Lanza评分均小于治疗前,且四联组溃疡直径、胃黏膜损伤Lanza评分小于三联组(P<0.05);两组治疗后IL-2、IL-6水平均低于治疗前,且四联组IL-2、IL-6水平低于三联组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);两组治疗后QLICD-PU评分高于治疗前,且四联组QLICD-PU评分高于三联组(P<0.05);四联组胃溃疡复发率低于三联组(P<0.05)。结论含铋剂四联疗法治疗消化性溃疡的效果确切,可促进溃疡愈合,缓解体内炎症,有利于预后生活质量的改善,且复发率低,用药安全性佳。

Objective To study the clinical efficacy of bismuth-containing quadruple therapy in the treatment of peptic ulcer patients and its effect on ulcer healing and inflammatory factors.Methods A total of 60 patients with peptic ulcer admitted to the Department of Gastroenterology,Jiangxi Dexing Hospital from May 2020 to May 2023 were selected as the research objects.They were divided into triple group(30 patients)and quadruple group(30 patients)by random number table method.The triple group was treated with triple therapy(rabeprazole+amoxicillin+clarithromycin),and the quadruple group was treated with bismuth-containing quadruple therapy(colloidal bismuth pectin+rabeprazole+amoxicillin+clarithromycin).The clinical efficacy,ulcer healing(ulcer diameter,Lanza score of gastric mucosal injury),inflammatory factors[interleukin-2(IL-2),interleukin-6(IL-6)],adverse reactions,prognosis[peptic ulcer scale(QLICD-PU),gastric ulcer recurrence rate]were compared between the two groups.Results The total effective rate of treatment in the quadruple group was 96.67%,which was higher than 80.00%in the triple group(P<0.05).After treatment,the ulcer diameter and Lanza score of gastric mucosal injury in the two groups were lower than those before treatment,and the ulcer diameter and Lanza score of gastric mucosal injury in the quadruple group were lower than those in the triple group(P<0.05).After treatment,the levels of IL-2 and IL-6 in the two groups were lower than those before treatment,and the levels of IL-2 and IL-6 in the quadruple group were lower than those in the triple group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The QLICD-PU score of the two groups after treatment was higher than that before treatment,and the QLICD-PU score of the quadruple group was higher than that of the triple group(P<0.05).The recurrence rate of gastric ulcer in quadruple group was lower than that in triple group(P<0.05).Conclusion Bismuth-containing quadruple therapy is effective in the treatment of peptic ulcer,which can promote ulcer healing,relieve inflammation in the body,improve the quality of life of prognosis,and has low recurrence rate and good drug safety.