四联疗法联合口腔洁治根除消化性溃疡合并幽门螺杆菌感染的疗效研究
|
摘要
目的探讨四联疗法联合口腔洁治根除消化性溃疡合并幽门螺杆菌(helicobacter pylori,Hp)感染初治者的疗效。方法 246例合并胃及口腔Hp感染初治消化性溃疡者采用随机数字表法随机分入对照组和试验组。对照组123例患者予泮托拉唑+胶体果胶铋+克拉霉素+阿莫西林四联疗法治疗;试验组123例患者在对照组基础上另外给予口腔洁治处理。两组患者均完成2周药物治疗。治疗结束后4周对两组患者胃及口腔Hp根除情况进行评估。治疗结束后随访1年,评估两组患者胃及口腔Hp感染复发率。结果治疗结束4周时,试验组和对照组胃Hp根除率分别为91.06%和78.86%,差异有统计学意义(P<0.05)。试验组口腔Hp根除率分67.48%高于对照组44.72%(P<0.05)。随访结束时,试验组和对照组胃Hp感染复发率分别为24.11%和40.21%,差异有统计学意义(P<0.05)。试验组口腔Hp感染复发率41.96%低于对照组74.23%(P<0.05)。结论口腔洁治可提高四联疗法根除消化性溃疡患者胃和口腔Hp的临床疗效,减少胃和口腔Hp感染复发率。
Objective To investigate the efficacy of the quadruple therapy combined with oral scaling in eradicating the helicobacter pylori(Hp)infection in patients with peptic ulcer.Methods 246 patients with peptic ulcer complicated with the gastric and oral Hp infection were divided into the experiment group and control group according to the random number table and each group consisted of 123 cases.The control group was given the quadruple therapy with pantoprazole,bismuth pectin,clarithromycin and amoxicillin,while the experiment group was treated with the same quadruple therapy combined with oral scaling.The patients of both groups were treated for 2 weeks and the eradication rates of the gastric and oral Hp infection were assessed 4 weeks after treatment.The patients of both groups were followed up for 1 year to assess the reinfection rate.Results The eradication rates of gastric and oral Hp infection in the experiment group were 91.06% and 67.48% respectively and those in the control group were 78.86% and 44.72% respectively,and the differences were statistically different(P<0.05).The reinfection rates of gastric and oral Hp infection in the experiment group were 24.11%and 41.96%respectively and those in the control group were 40.21% and 74.23 respectively,and the differences were statistically different(P<0.05).Conclusion The oral scaling can improve the efficacy of the quadruple therapy in eradicating the oral and gastric Hp infection and reduce the oral and gastric Hp reinfection in patients with peptic ulcer.
Objective To investigate the efficacy of the quadruple therapy combined with oral scaling in eradicating the helicobacter pylori(Hp)infection in patients with peptic ulcer.Methods 246 patients with peptic ulcer complicated with the gastric and oral Hp infection were divided into the experiment group and control group according to the random number table and each group consisted of 123 cases.The control group was given the quadruple therapy with pantoprazole,bismuth pectin,clarithromycin and amoxicillin,while the experiment group was treated with the same quadruple therapy combined with oral scaling.The patients of both groups were treated for 2 weeks and the eradication rates of the gastric and oral Hp infection were assessed 4 weeks after treatment.The patients of both groups were followed up for 1 year to assess the reinfection rate.Results The eradication rates of gastric and oral Hp infection in the experiment group were 91.06% and 67.48% respectively and those in the control group were 78.86% and 44.72% respectively,and the differences were statistically different(P<0.05).The reinfection rates of gastric and oral Hp infection in the experiment group were 24.11%and 41.96%respectively and those in the control group were 40.21% and 74.23 respectively,and the differences were statistically different(P<0.05).Conclusion The oral scaling can improve the efficacy of the quadruple therapy in eradicating the oral and gastric Hp infection and reduce the oral and gastric Hp reinfection in patients with peptic ulcer.
引文
[1]Warren J R,Marshall B.Unidentified curved bacilli on gastric epithelium in active chronic gastritis[J].Lancet,1983,1(8336):1273-1275.
[2]中华消化杂志编委会.消化性溃疡诊断与治疗规范(2016年,西安)[J].中华消化杂志,2016,36(8):508-513.
[3]Lang L.Barry Marshall 2005Nobel laureate in medicine and physiology[J].Gastroenterology,2005,129(6):1813-1814.
[4]胡伏莲.《幽门螺杆菌感染若干问题共识意见》解读[J].中国医刊,2007,42(1):4-6.
[5]潘雯,陈霞,陈旭平.幽门螺杆菌根除治疗不同方案的临床疗效观察[J].临床医药文献电子杂志,2014(5):672-674.
[6]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.第四次全国幽门螺杆菌感染处理共识报告[J].内科理论与实践,2013,8(1):54-60.
[7]Malfertheiner P,Megraud F,O'Morain C A,et al.Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report[J].Gut,2017,66(1):6-30.
[8]Chuah S K,Tsay F W,Hsu P I,et al.A new look at antiHelicobacter pylori therapy[J].World J Gastroenterol,2011,17(35):3971-3975.
[9]甘远,黄方华,王瑞云,等.幽门螺杆菌感染的治疗现状及进展[J].海南医学,2016,27(9):1483-1485.
[10]Sun Q,Liang X,Zheng Q,et al.High Efficacy of 14-Day Triple Therapy-Based,Bismuth-Containing Quadruple Therapy for Initial Helicobacter pylori Eradication[J].Helicobacter,2010,15(3):233-238.
[11]徐美华,张桂英,李常娟.含铋剂四联一线治疗方案根除幽门螺杆菌疗效观察[J].浙江大学学报(医学版),2011,40(3):327-331.
[12]Krajden S,Fuksa M,Anderson J,et al.Examination of human stomach biopsies,saliva,and dental plaque for Campylobacter pylori[J].J Clin Microbiol,1989,27(6):1397-1398.
[13]万洋洋,陈相,赵枰,等.口腔与胃内幽门螺杆菌感染的相关性研究[J].国际检验医学杂志,2016,37(18):2566-2567,2570.
[14]楼晓军,沈灵娜,陈洁,等.口腔幽门螺杆菌感染与胃幽门螺杆菌感染及根除率的相关性[J].世界华人消化杂志,2016,24(18):2918-2922.
[15]杜顺华.口腔幽门螺杆菌感染对胃幽门螺杆菌根除和复发的影响[J].医学信息,2015(25):366-367.
[16]吴中平,吴晓茹,季峰.慢性胃炎患者口腔幽门螺杆菌感染对胃幽门螺杆菌根除率的影响[J].北京医学,2012,34(8):765-767.
[17]高文,胡伏莲,王晓敏.含呋喃唑酮的四联疗法联合口腔洁治对幽门螺杆菌根除多次失败的补救治疗[J].中华医学杂志,2011,91(12):836-839.
[18]孙佳,法永红,杨永进,等.幽门螺杆菌与口腔疾病的相关性研究进展[J].国际口腔医学杂志,2015,42(1):93-96.
[2]中华消化杂志编委会.消化性溃疡诊断与治疗规范(2016年,西安)[J].中华消化杂志,2016,36(8):508-513.
[3]Lang L.Barry Marshall 2005Nobel laureate in medicine and physiology[J].Gastroenterology,2005,129(6):1813-1814.
[4]胡伏莲.《幽门螺杆菌感染若干问题共识意见》解读[J].中国医刊,2007,42(1):4-6.
[5]潘雯,陈霞,陈旭平.幽门螺杆菌根除治疗不同方案的临床疗效观察[J].临床医药文献电子杂志,2014(5):672-674.
[6]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.第四次全国幽门螺杆菌感染处理共识报告[J].内科理论与实践,2013,8(1):54-60.
[7]Malfertheiner P,Megraud F,O'Morain C A,et al.Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report[J].Gut,2017,66(1):6-30.
[8]Chuah S K,Tsay F W,Hsu P I,et al.A new look at antiHelicobacter pylori therapy[J].World J Gastroenterol,2011,17(35):3971-3975.
[9]甘远,黄方华,王瑞云,等.幽门螺杆菌感染的治疗现状及进展[J].海南医学,2016,27(9):1483-1485.
[10]Sun Q,Liang X,Zheng Q,et al.High Efficacy of 14-Day Triple Therapy-Based,Bismuth-Containing Quadruple Therapy for Initial Helicobacter pylori Eradication[J].Helicobacter,2010,15(3):233-238.
[11]徐美华,张桂英,李常娟.含铋剂四联一线治疗方案根除幽门螺杆菌疗效观察[J].浙江大学学报(医学版),2011,40(3):327-331.
[12]Krajden S,Fuksa M,Anderson J,et al.Examination of human stomach biopsies,saliva,and dental plaque for Campylobacter pylori[J].J Clin Microbiol,1989,27(6):1397-1398.
[13]万洋洋,陈相,赵枰,等.口腔与胃内幽门螺杆菌感染的相关性研究[J].国际检验医学杂志,2016,37(18):2566-2567,2570.
[14]楼晓军,沈灵娜,陈洁,等.口腔幽门螺杆菌感染与胃幽门螺杆菌感染及根除率的相关性[J].世界华人消化杂志,2016,24(18):2918-2922.
[15]杜顺华.口腔幽门螺杆菌感染对胃幽门螺杆菌根除和复发的影响[J].医学信息,2015(25):366-367.
[16]吴中平,吴晓茹,季峰.慢性胃炎患者口腔幽门螺杆菌感染对胃幽门螺杆菌根除率的影响[J].北京医学,2012,34(8):765-767.
[17]高文,胡伏莲,王晓敏.含呋喃唑酮的四联疗法联合口腔洁治对幽门螺杆菌根除多次失败的补救治疗[J].中华医学杂志,2011,91(12):836-839.
[18]孙佳,法永红,杨永进,等.幽门螺杆菌与口腔疾病的相关性研究进展[J].国际口腔医学杂志,2015,42(1):93-96.