肝硬化幽门螺杆菌阳性患者“四联”与“五联”根除幽门螺杆菌的疗效比较
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摘要
目的探讨肝硬化幽门螺杆菌(Hp)阳性患者"四联"与"五联"根除Hp的疗效。方法选取河北省保定市第二中心医院2017年11月～2018年4月收治的肝硬化Hp阳性患者共180例作为研究对象,按照随机数字表法分为对照组(90例)和研究组(90例)。对照组给予"四联"治疗,研究组患者给予"五联"治疗。观察研究两组患者治疗后的Hp根除效果和黏膜修复情况、不良反应发生率、治疗前后肝功能比较以及肝纤维化指标。结果研究组患者的Hp根除率和黏膜修复情况明显好于对照组(P <0.05);研究组不良反应发生率明显低于对照组(P <0.05);研究组肝功能明显好于对照组(P <0.05);研究组肝纤维化指标明显好于对照组(P <0.05)。结论 "四联"与"五联"根除Hp治疗肝硬化Hp阳性患者均具有一定的效果,"五联"的治疗效果更加明显,临床价值更加突出,值得在临床上进一步推广应用。
Objective To compare the efficacy of "quadruple" and "quintuplicate" in the eradication of Helicobacter pylori(Hp) in patients with liver cirrhosis and positive Hp. Methods A total of 180 Hp positive patients with liver cirrhosis admitted to Baoding Second Central Hospital of Heibei Province from November 2017 to April 2018 were selected as the research objects, and they were divided into the control group(90 cases) and the research group(90 cases)according to the random number table method. The control group was treated with "quadruple" therapy, and the study group was treated with "quintuplicate" therapy. The eradication effect, mucosal repair, incidence of adverse reactions,liver function before and after treatment, and indexes of liver fibrosis in the two groups were observed and studied. Results The eradication rate and mucosal repair of patients in the study group were significantly better than those in the control group(P < 0.05). The incidence of adverse reactions in the study group was significantly lower than that in the control group(P < 0.05). The liver function of the study group was significantly better than that of the control group(P <0.05). The indexes of liver fibrosis in the study group were significantly better than those in the control group(P <0.05). Conclusion Both "quadruple" and "quintuplicate" have certain curative effect in the eradication of Hp in the treatment of Hp positive patients with liver cirrhosis. The treatment effect of "quintuplicate" is more obvious and the clinical value is more prominent, which is worthy of further promotion and application in clinical practice.
Objective To compare the efficacy of "quadruple" and "quintuplicate" in the eradication of Helicobacter pylori(Hp) in patients with liver cirrhosis and positive Hp. Methods A total of 180 Hp positive patients with liver cirrhosis admitted to Baoding Second Central Hospital of Heibei Province from November 2017 to April 2018 were selected as the research objects, and they were divided into the control group(90 cases) and the research group(90 cases)according to the random number table method. The control group was treated with "quadruple" therapy, and the study group was treated with "quintuplicate" therapy. The eradication effect, mucosal repair, incidence of adverse reactions,liver function before and after treatment, and indexes of liver fibrosis in the two groups were observed and studied. Results The eradication rate and mucosal repair of patients in the study group were significantly better than those in the control group(P < 0.05). The incidence of adverse reactions in the study group was significantly lower than that in the control group(P < 0.05). The liver function of the study group was significantly better than that of the control group(P <0.05). The indexes of liver fibrosis in the study group were significantly better than those in the control group(P <0.05). Conclusion Both "quadruple" and "quintuplicate" have certain curative effect in the eradication of Hp in the treatment of Hp positive patients with liver cirrhosis. The treatment effect of "quintuplicate" is more obvious and the clinical value is more prominent, which is worthy of further promotion and application in clinical practice.
引文
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[10]朱俊,袁玉林,陈敏,等.慢性肝病幽门螺杆菌感染患者白细胞介素水平测定的临床研究[J].中华医院感染学杂志,2016,26(16):3638-3639.
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[12]胡佳丽,兰春慧,张昊翔,等.不同疗程铋剂四联疗法在中国根治幽门螺杆菌感染疗效的Meta分析[J].第三军医大学学报,2017,39(10):1044-1055.
[13]张梦,陈超英,王霄腾,等.左氧氟沙星为基础的三联疗法与铋剂四联疗法作为二线疗法根除幽门螺杆菌的Meta分析[J].中华内科杂志,2017,56(5):368-374.
[14]高文,胡伏莲,成虹,等.国产药物组成的四联疗法对胃炎及十二指肠溃疡患者幽门螺杆菌感染根除效果的前瞻性多中心随机对照研究[J].中华医学杂志,2016,96(4):260-264.
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[16]李恕军,方洒,金鹏,等.陆军某部官兵心理状况调查及其与幽门螺杆菌感染的关系[J].解放军医学杂志,2017,42(2):172-176.
[17]林冠凯,李保良,张琪.和胃愈疡颗粒结合四联疗法治疗寒热错杂型幽门螺杆菌相关性消化性溃疡的临床研究[J].中药材,2017,40(6):1465-1467.
[18]刘宇,杨小军,田锋亮,等.重庆地区幽门螺杆菌耐药个体化治疗70例[J].重庆医学,2017,46(22):3130-3132.
[19]周钢,胡毅,赵正中.慢性阻塞性肺疾病患者幽门螺杆菌耐药状况研究[J].重庆医学,2017,46(21):2914-2916.
[20]俞文,艾尼·阿布都热依木,雪来提·艾孜木,等.不同剂量艾司奥美拉唑镁为基础的四联方案治疗248例维吾尔族幽门螺杆菌性胃炎的疗效观察[J].中华消化杂志,2017,37(3):172-178.
[21]张富东,杨思芸,苏强,等.南充市城区消化性溃疡患者抗幽门螺杆菌规范治疗情况分析[J].广东医学,2017,38(5):775-777.
[2]Niv Y.Doxycycline in Eradication Therapy of Helicobacter pylori-A Systematic Review and Meta-Analysis[J].Digestion,2016,93(2):167.
[3]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.
[4]Sapmaz F,Bas覨yiˇgit S,Kalkan I H,et al.The impact of Helicobacter pylori eradication on serum hepcidin-25 level and iron parameters in patients with iron deficiency anemia[J].Wiener Klinische Wochenschrift,2016,128(9/10):335-340.
[5]李桂水,杨敏京,边连朵,等.四联疗法联合口腔洁治对胃溃疡患者胃幽门螺杆菌根除的临床疗效观察[J].中国现代医学杂志,2016,26(5):140-142.
[6]陈德清,何松,左的于,等.四联疗法治疗2型糖尿病合并幽门螺杆菌阳性消化性溃疡的临床研究[J].中国临床药理学杂志,2017,33(12):1091-1093.
[7]Cerqueira RM,Correia MR,Vilar H,et al.How Effective Is the Quadruple Concomitant Helicobacter Pylori Eradication Therapy for Obese Patients Undergoing Gastric Bypass Surgery?[J].Obesity Surgery,2016,26(6):1163-1166.
[8]王娟,杨兵,戴可可,等.幽门螺杆菌感染对慢性乙型肝炎及乙肝肝硬化患者消化道溃疡的临床影响[J].中华医院感染学杂志,2017,27(14):3200-3203.
[9]陈轶,陈益耀,韩向阳,等.幽门螺杆菌与乙型肝炎病毒对乙型病毒性肝炎患者胃黏膜病变的相关分析[J].中华医院感染学杂志,2016,26(14):3184-3186.
[10]朱俊,袁玉林,陈敏,等.慢性肝病幽门螺杆菌感染患者白细胞介素水平测定的临床研究[J].中华医院感染学杂志,2016,26(16):3638-3639.
[11]Jin KB,Hyun-Soo K,Song HJ,et al.Online Registry for Nationwide Database of Current Trend of Helicobacter pylori Eradication in Korea:Interim Analysis[J].J Korean Med Sci,2016,31(8):1246-1253.
[12]胡佳丽,兰春慧,张昊翔,等.不同疗程铋剂四联疗法在中国根治幽门螺杆菌感染疗效的Meta分析[J].第三军医大学学报,2017,39(10):1044-1055.
[13]张梦,陈超英,王霄腾,等.左氧氟沙星为基础的三联疗法与铋剂四联疗法作为二线疗法根除幽门螺杆菌的Meta分析[J].中华内科杂志,2017,56(5):368-374.
[14]高文,胡伏莲,成虹,等.国产药物组成的四联疗法对胃炎及十二指肠溃疡患者幽门螺杆菌感染根除效果的前瞻性多中心随机对照研究[J].中华医学杂志,2016,96(4):260-264.
[15]Unler GK,Teke Ozgur G,Gokturk HS,et al.A Comparison of Five Different Treatment Regimens as the First‐Line Treatment of Helicobacter pylori in Turkey[J].Helicobacter,2015,21(4):279-285.
[16]李恕军,方洒,金鹏,等.陆军某部官兵心理状况调查及其与幽门螺杆菌感染的关系[J].解放军医学杂志,2017,42(2):172-176.
[17]林冠凯,李保良,张琪.和胃愈疡颗粒结合四联疗法治疗寒热错杂型幽门螺杆菌相关性消化性溃疡的临床研究[J].中药材,2017,40(6):1465-1467.
[18]刘宇,杨小军,田锋亮,等.重庆地区幽门螺杆菌耐药个体化治疗70例[J].重庆医学,2017,46(22):3130-3132.
[19]周钢,胡毅,赵正中.慢性阻塞性肺疾病患者幽门螺杆菌耐药状况研究[J].重庆医学,2017,46(21):2914-2916.
[20]俞文,艾尼·阿布都热依木,雪来提·艾孜木,等.不同剂量艾司奥美拉唑镁为基础的四联方案治疗248例维吾尔族幽门螺杆菌性胃炎的疗效观察[J].中华消化杂志,2017,37(3):172-178.
[21]张富东,杨思芸,苏强,等.南充市城区消化性溃疡患者抗幽门螺杆菌规范治疗情况分析[J].广东医学,2017,38(5):775-777.