含果胶铋剂的四联疗法治疗幽门螺杆菌阳性消化性溃疡的疗效及安全性分析
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摘要
目的 探讨含果胶铋剂的四联疗法治疗幽门螺杆菌(Helicobacterpylori,Hp)阳性消化性溃疡的疗效及安全性。方法 选取我院2014年5月—2017年8月的130例消化性溃疡合并Hp阳性患者,随机分为研究组(n=67)和对照组(n=63),研究组患者给予胶体果胶铋胶囊+克拉霉素分散片+阿莫西林胶囊+奥美拉唑胶囊治疗,对照组予克拉霉素分散片+阿莫西林胶囊+奥美拉唑胶囊治疗,对比分析两组患者的临床疗效及安全性。结果 研究组Hp根除率为92.54%,明显高于对照组的76.19%,差异具有统计学意义(P<0.05);研究组消化性溃疡愈合率为91.04%,明显高于对照组的77.78%,差异具有统计学意义(P<0.05);两组患者的临床症状评分均明显低于治疗前(P<0.05),且研究组显著低于对照组(P<0.001);研究组与对照组治疗期间不良反应发生率差异比较无统计学意义(P>0.05)。结论 含果胶铋剂的四联疗法在治疗消化性溃疡并Hp阳性患者中的疗效优于三联疗法,且不良反应发生率不增加,可以作为治疗消化性溃疡并Hp阳性患者的首选方案。
Objective To investigate the efficacy and safety of quadruple therapy containing bismuth pectin agent in treatment of peptic ulcer with positive Helicobacter pylori(Hp). Methods A total of 130 peptic ulcer patients associated with positive Hp in our hospital from May 2014 to August 2017 were randomly divided into a study group(n=67) and a control group(n=63).The study group was treated with Colloidal Pectin Bismuth Capsules + Clarithromycin Dispersible Tablets + Amoxicillin Capsules + Omeprazole Capsules. The control group was treated with Clarithromycin Dispersible Tablets + Amoxicillin Capsules + Omeprazole Capsules. The clinical efficacy and safety of the two groups were compared and analyzed. Results The eradication rate of Hp in the study group was 92.54%, which was significantly higher than that in the control group(76.19%), and the difference was statistically significant(P<0.05). The healing rate of peptic ulcer was 91.04% in the study group, which was significantly higher than that in the control group(77.78%) and the difference was statistically significant(P<0.05). Clinical symptom scores of patients in the two groups were significantly lower than those before treatment(P<0.05), moreover, the clinical symptom scores of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group and the control group during treatment(P>0.05). Conclusion The quadruple therapy containing pectin bismuth agent is better than the triple therapy in the treatment of patients with peptic ulcer associated with positive Hp, and the incidence of adverse reactions is not increased, and it can be used as the first choice for the treatment of peptic ulcer patients with positive Hp.
Objective To investigate the efficacy and safety of quadruple therapy containing bismuth pectin agent in treatment of peptic ulcer with positive Helicobacter pylori(Hp). Methods A total of 130 peptic ulcer patients associated with positive Hp in our hospital from May 2014 to August 2017 were randomly divided into a study group(n=67) and a control group(n=63).The study group was treated with Colloidal Pectin Bismuth Capsules + Clarithromycin Dispersible Tablets + Amoxicillin Capsules + Omeprazole Capsules. The control group was treated with Clarithromycin Dispersible Tablets + Amoxicillin Capsules + Omeprazole Capsules. The clinical efficacy and safety of the two groups were compared and analyzed. Results The eradication rate of Hp in the study group was 92.54%, which was significantly higher than that in the control group(76.19%), and the difference was statistically significant(P<0.05). The healing rate of peptic ulcer was 91.04% in the study group, which was significantly higher than that in the control group(77.78%) and the difference was statistically significant(P<0.05). Clinical symptom scores of patients in the two groups were significantly lower than those before treatment(P<0.05), moreover, the clinical symptom scores of the study group were significantly lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group and the control group during treatment(P>0.05). Conclusion The quadruple therapy containing pectin bismuth agent is better than the triple therapy in the treatment of patients with peptic ulcer associated with positive Hp, and the incidence of adverse reactions is not increased, and it can be used as the first choice for the treatment of peptic ulcer patients with positive Hp.
引文
[1] 李生利.消化性溃疡患者幽门螺杆菌感染状况及耐药性分析[J].临床心身疾病杂志,2017,23(6):121-123.
[2] 富云霞.幽门螺杆菌的根除率与消化道疾病的影响[J].现代养生,2016(4):43-44.
[3] Xie C,Lu NH.Review Clinical Management of Helicobacter pylori Infection in China[J].Helicobacter,2015,20(1):1-10.
[4] Graham DY,Fischbach L.Helicobacter pylori treatment in the era of increasing antibiotic resistance[J].Gut,2010,59(8):1143-53.
[5] 中华医学会消化病学分会幽门螺杆菌学组/全国幽门螺杆菌研究协作组,刘文忠,谢勇,等.第四次全国幽门螺杆菌感染处理共识报告[J].中华消化杂志,2012,32(10):655-661.
[6] 余艳秋,王建宁,翟启智,等.含左氧氟沙星的四联药物10日序贯疗法根除幽门螺杆菌疗效观察[J].山东医药,2013,53(30):64-65.
[7] Choudhary S,Jain A,Amin MCIM,et al.Stomach specific polymeric low density microballoons as a vector for extended delivery of rabeprazole and amoxicillin for treatment of peptic ulcer[J].Colloids Surf B Biointerfaces,2016,141:268-277.
[8] 王东升,吴丽波,胡中桥.幽门螺杆菌感染消化性溃疡治疗的疗效分析[J].中华医院感染学杂志,2014,24(4):921-923.
[9] 唐艳波,林中,张剑波,等.桂林地区幽门螺杆菌的耐药性分析[J].右江民族医学院学报,2014,36(2):211-212.
[10] Malfertheiner P,Bazzoli F,Delchier J C,et al.Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium,metronidazole,and tetracycline given with omeprazole versus clarithromycin-based triple therapy:a randomised,open-label,non-inferiority,phase 3 trial[J].Lancet,2011,377(9769):905-913.
[11] 齐秀荣,赵景成,宗湘裕.雷贝拉唑钠联合枸橼酸铋钾治疗消化性溃疡的临床疗效观察[J].医学综述,2014,20(12):2294-2295.
[12] 张宏,侯波,严江.常规三联与四联疗法治疗幽门螺杆菌阳性消化道溃疡的疗效比较[J].中国药房,2017,28(3).321-323.
[13] 杨东茹,罗锦强,张瑞群,等.延长奥美拉唑治疗时间对儿童幽门螺杆菌根除率的影响[J].实用医学杂志,2015,31(14):2409-2410.
[14] Ford A C,Malfertheiner P,Giguère M,et al.Adverse events with bismuth salts for Helicobacter pylori eradication:Systematic review and meta-analysis[J].World Journal of Gastroenterology,2008,14(48):7361-7370.
[2] 富云霞.幽门螺杆菌的根除率与消化道疾病的影响[J].现代养生,2016(4):43-44.
[3] Xie C,Lu NH.Review Clinical Management of Helicobacter pylori Infection in China[J].Helicobacter,2015,20(1):1-10.
[4] Graham DY,Fischbach L.Helicobacter pylori treatment in the era of increasing antibiotic resistance[J].Gut,2010,59(8):1143-53.
[5] 中华医学会消化病学分会幽门螺杆菌学组/全国幽门螺杆菌研究协作组,刘文忠,谢勇,等.第四次全国幽门螺杆菌感染处理共识报告[J].中华消化杂志,2012,32(10):655-661.
[6] 余艳秋,王建宁,翟启智,等.含左氧氟沙星的四联药物10日序贯疗法根除幽门螺杆菌疗效观察[J].山东医药,2013,53(30):64-65.
[7] Choudhary S,Jain A,Amin MCIM,et al.Stomach specific polymeric low density microballoons as a vector for extended delivery of rabeprazole and amoxicillin for treatment of peptic ulcer[J].Colloids Surf B Biointerfaces,2016,141:268-277.
[8] 王东升,吴丽波,胡中桥.幽门螺杆菌感染消化性溃疡治疗的疗效分析[J].中华医院感染学杂志,2014,24(4):921-923.
[9] 唐艳波,林中,张剑波,等.桂林地区幽门螺杆菌的耐药性分析[J].右江民族医学院学报,2014,36(2):211-212.
[10] Malfertheiner P,Bazzoli F,Delchier J C,et al.Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium,metronidazole,and tetracycline given with omeprazole versus clarithromycin-based triple therapy:a randomised,open-label,non-inferiority,phase 3 trial[J].Lancet,2011,377(9769):905-913.
[11] 齐秀荣,赵景成,宗湘裕.雷贝拉唑钠联合枸橼酸铋钾治疗消化性溃疡的临床疗效观察[J].医学综述,2014,20(12):2294-2295.
[12] 张宏,侯波,严江.常规三联与四联疗法治疗幽门螺杆菌阳性消化道溃疡的疗效比较[J].中国药房,2017,28(3).321-323.
[13] 杨东茹,罗锦强,张瑞群,等.延长奥美拉唑治疗时间对儿童幽门螺杆菌根除率的影响[J].实用医学杂志,2015,31(14):2409-2410.
[14] Ford A C,Malfertheiner P,Giguère M,et al.Adverse events with bismuth salts for Helicobacter pylori eradication:Systematic review and meta-analysis[J].World Journal of Gastroenterology,2008,14(48):7361-7370.