摘要
[目的]探讨3种艾司奥美拉唑给药方案对幽门螺杆菌(Hp)阳性浅表性胃炎患者疗效及安全性的影响,为临床治疗提供依据。[方法]选择2016年1月~2018年12月在我院就诊的Hp阳性浅表性胃炎患者180例,按照随机数字表法将患者分为高剂量组、标准剂量组和单剂量组,各60例。高剂量组给予艾司奥美拉唑肠溶片40 mg,2次/d;标准剂量组给予艾司奥美拉唑肠溶片20 mg,2次/d;单剂量组给予艾司奥美拉唑肠溶片40 mg,1次/d,所有患者在服用艾司奥美拉唑肠溶片的基础上服用克拉霉素缓释片、阿莫西林胶囊、胃铋镁颗粒。检测患者Hp彻底根除率、胃肠激素水平,记录患者消化不良症状积分、临床疗效、不良反应等。[结果]高剂量组Hp根除率为90.00%,显著高于标准剂量组(75.00%)和单剂量组(56.67%)(P=0.000),标准剂量组Hp根除率显著高于单剂量组(P=0.034)。治疗后,3组患者胃泌素、MDA水平显著低于治疗前,且高剂量组低于标准剂量组低于单剂量组。3组患者的SOD水平显著高于治疗前,高剂量组高于标准剂量组高于单剂量组(P<0.05)。治疗后,3组患者消化不良各项症状积分均显著降低,且高剂量组各项积分均显著低于标准剂量组和单剂量组,标准剂量组各项积分显著低于单剂量组(P<0.05);高剂量组有效率为93.33%,显著高于标准剂量组(75.00%)和单剂量组(51.67%)(P<0.000),标准剂量组有效率显著高于单剂量组(P=0.008);3组患者不良反应比较差异无统计学意义。[结论]高剂量艾司奥美拉唑联合克拉霉素和阿莫西林和铋剂能够显著提高Hp根除率,提高临床疗效,且具有较好的安全性。
[Objective]To investigate the effect of three esomeprazole administration regimens on the efficacy and safety of H.pylori-positive superficial gastritis,and to provide evidence for clinical treatment.[Methods]A total of 180 patients with Hp-positive superficial gastritis who were admitted to our hospital from January 2016 to December 2018 were enrolled.The patients were divided into high-dose,standard-dose,and single-dose groups according to the random number table.High-dose group was given Esomeprazole enteric-coated tablets 40 mg twice daily;standard dose group was given Esomeprazole enteric-coated tablets 20 mg twice daily;single-dose group was given Esomeprazole 40 mg of enteric-coated tablets,all patients took clarithromycin sustained-release tablets,amoxicillin capsules,and stomach sputum magnesium granules on the basis of taking esomeprazole enteric-coated tablets.The patient’s Hp eradication rate and gastrointestinal hormone levels were measured,and the patient’s dyspeptic symptom scores,clinical efficacy,and adverse reactions were recorded.[Results]The Hp eradication rate was 90.00%in the high-dose group,which was significantly higher than the standard-dose group(75.00%)and the single-dose group(56.67%),(χ~2=4.675,P=0.031;χ~2=17.045,P=0.000)The eradication rate of H.pylori in the standard dose group was significantly higher than that in the single dose group(χ~2=4.483,P=0.034).After treatment,the levels of gastrin and MDA in the three groups were significantly lower than those before treatment,and the high dose group was lower than the standard.The dose group was lower than the single dose group;the SOD level of the three groups was significantly higher than that before the treatment,and the high dose group was higher than the standard dose group than the single dose group(P<0.05);after treatment,three The scores of dyspepsia in the patients were significantly lower,and the scores in the high-dose group were significantly lower than those in the standard-dose group and the single-dose group.The scores in the standard-dose group were significantly lower than those in the single-dose group(P<0.05);the effective rate of high dose group was 93.33%,which was significantly higher than the standard dose group(75.00%)and the single dose group(51.67%)(χ~2=7.556,P=0.006;χ~2=26.123,P<0.000)The standard dose group was significantly more effective than the single dose group(χ~2=7.033,P=0.008);three groups of patients Adverse reactions difference was not statistically significant(P>0.05).[Conclusion]High-dose Esomeprazole combined with clarithromycin and amoxicillin and expectorant can significantly improve Hp eradication rate,improve clinical efficacy,and have better safety.
作者
余莹
王佳佳
徐银姝
YU Ying;WANG Jia-jia;XU Yin-shu(Department of Pharmacy,Chinese Medicine Hospital,Hangzhou 310006,China)
出处
《中国中西医结合消化杂志》
CAS
2019年第6期447-451,共5页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
