艾司奥美拉唑镁肠溶片治疗消化性溃疡合并幽门螺杆菌感染的临床研究
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摘要
目的观察艾司奥美拉唑镁肠溶片治疗消化性溃疡合并幽门螺杆菌(Hp)感染的临床研究及其对血清与胃液白细胞介素(IL)-6、IL-8的影响。方法将90例消化性溃疡合并幽门螺杆菌感染患者随机分为对照组(n=45)和试验组(n=45)。对照组口服奥美拉唑肠溶胶囊40 mg,每天2次,连续治疗14 d。试验组口服艾司奥美拉唑镁肠溶片40 mg,每天1次,服用5 d,之后口服抗幽门螺杆菌方案,共14 d。比较2组患者的溃疡愈合疗效、治疗后幽门螺杆菌阳性率,并比较治疗前后血清和胃液中IL-6、IL-8及临床症状积分的变化和药物不良反应发生情况。结果治疗后,试验组和对照组溃疡总愈合率分别为86.67%(39例/45例),66.67%(30例/45例);幽门螺杆菌阳性率分别为11.11%(5例/45例),28.89%(13例/45例),差异均有统计学意义(均P<0.05)。治疗后,试验组血清IL-6和IL-8分别为(57.59±6.14),(49.89±4.84)pg·mL~(-1),胃液中IL-6和IL-8分别为(17.14±2.79),(12.40±1.11)pg·mL~(-1);对照组血清IL-6和IL-8分别为(74.47±7.86),(59.67±6.12)pg·mL~(-1),胃液中IL-6和IL-8分别为(23.79±3.36),(18.17±1.89)pg·mL~(-1),差异均有统计学意义(均P<0.05)。对照组出现头晕头痛3例,皮疹2例,腹泻1例,药物不良反应发生率为13.33%(6例/45例);试验组出现头晕头痛4例,胃肠道不适2例,口干1例,眩晕1例,药物不良反应发生率为17.78%(8例/45例),差异无统计学意义(P>0.05)。结论艾司奥美拉唑镁肠溶片治疗消化性溃疡合并幽门螺杆菌感染的临床疗效显著。
Objective To observe the clinical effect of esomeprazole magnesium enteric-coated tablets in the treatment of patients with peptic ulcer and Helicobacter pylori( Hp) infection and its effects on serum and gastric interleukins( IL)-6,IL-8 levels. Methods Ninety patients of peptic ulcer with Hp infection were randomly divided into treatment group( n = 45) and control group( n = 45). Control group was given omeprazole enteric-coated capsules 40 mg,bid,for 14 d. Treatment group was orally given esomeprazole 40 mg,qd,for 5 d,and then given the anti Hp regimen for 14 d. The clinical effect of ulcer healing and Hp positive rate after treatment between two groups were compared,the serum and gastric juice interleukins( IL)-6,IL-8 and clinical symptomscores before and after treatment and adverse drug reaction between two groups were compared. Results After treatment,the total healing rates of treatment group and control group were 86. 67%( 39 cases/45 cases),66. 67%( 30 cases/45 cases),the Hp positive rates in treatment group and control group were 11. 11%( 5 cases/45 cases),28. 89%( 13 cases/45 cases),all with significant differences( all P < 0. 05). After treatment,the serum IL-6 and IL-8 in treatment group were( 57. 59 ± 6. 14),( 49. 89 ± 4. 84) pg · mL~(-1),the gastric IL-6 and IL-8 were( 17. 14 ± 2. 79),( 12. 40 ± 1. 11) pg·mL~(-1); the serum IL-6 and IL-8 in control group were( 74. 47 ± 7. 86),( 59. 67 ± 6. 12) pg·mL~(-1),the gastric IL-6 and IL-8 were( 23. 79 ± 3. 36),( 18. 17 ± 1. 89) pg·mL~(-1),all with significant differences( all P < 0. 05). There were 3 cases of dizziness,2 cases of rash,and 1 cases of diarrhea in control group,with the incidence of 13. 33%( 6 cases/45 cases). There were 4 cases of dizziness and headache,2 cases of gastrointestinal discomfort,1 cases of dry mouth,and 1 case of vertigo in treatment group,with the incidence of 17. 78%( 8 cases/45 cases),with no significant difference( P > 0. 05). Conclusion Esomeprazole magnesium enteric-coated tablets is good for peptic ulcer with Hp infection.
Objective To observe the clinical effect of esomeprazole magnesium enteric-coated tablets in the treatment of patients with peptic ulcer and Helicobacter pylori( Hp) infection and its effects on serum and gastric interleukins( IL)-6,IL-8 levels. Methods Ninety patients of peptic ulcer with Hp infection were randomly divided into treatment group( n = 45) and control group( n = 45). Control group was given omeprazole enteric-coated capsules 40 mg,bid,for 14 d. Treatment group was orally given esomeprazole 40 mg,qd,for 5 d,and then given the anti Hp regimen for 14 d. The clinical effect of ulcer healing and Hp positive rate after treatment between two groups were compared,the serum and gastric juice interleukins( IL)-6,IL-8 and clinical symptomscores before and after treatment and adverse drug reaction between two groups were compared. Results After treatment,the total healing rates of treatment group and control group were 86. 67%( 39 cases/45 cases),66. 67%( 30 cases/45 cases),the Hp positive rates in treatment group and control group were 11. 11%( 5 cases/45 cases),28. 89%( 13 cases/45 cases),all with significant differences( all P < 0. 05). After treatment,the serum IL-6 and IL-8 in treatment group were( 57. 59 ± 6. 14),( 49. 89 ± 4. 84) pg · mL~(-1),the gastric IL-6 and IL-8 were( 17. 14 ± 2. 79),( 12. 40 ± 1. 11) pg·mL~(-1); the serum IL-6 and IL-8 in control group were( 74. 47 ± 7. 86),( 59. 67 ± 6. 12) pg·mL~(-1),the gastric IL-6 and IL-8 were( 23. 79 ± 3. 36),( 18. 17 ± 1. 89) pg·mL~(-1),all with significant differences( all P < 0. 05). There were 3 cases of dizziness,2 cases of rash,and 1 cases of diarrhea in control group,with the incidence of 13. 33%( 6 cases/45 cases). There were 4 cases of dizziness and headache,2 cases of gastrointestinal discomfort,1 cases of dry mouth,and 1 case of vertigo in treatment group,with the incidence of 17. 78%( 8 cases/45 cases),with no significant difference( P > 0. 05). Conclusion Esomeprazole magnesium enteric-coated tablets is good for peptic ulcer with Hp infection.
引文
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[6]MORI H,SUZUKI H,MATSUZAKI J,et al.Antibiotic resistance and gyr A mutation affect the efficacy of 10-day sitafloxacin-metronidazole-esomeprazole therapy for helicobacter pylori in penicillin allergic patients[J].United European Gastroenterol J,2017,5(6):796-804.
[7]骆丹东,傅小玲,吴警伟.消化性溃疡出血患者血清及胃液中白细胞介素的表达与幽门螺杆菌感染关系[J].中华医院感染学杂志,2015,25(6):1242-1244.
[8]HUXFORD K E,DART A J,PERKINS N R,et al.A pilot study comparing the effect of orally administered esomeprazole and omeprazole on gastric fluid pH in horses[J].N Z Vet J,2017,65(6):318-321.
[9]保志军,黄一沁,郑松柏,等.艾司奥美拉唑为基础的三联疗法根除幽门螺杆菌的荟萃分析[J].中国新药与临床杂志,2007,26(1):48-52.
[2]UCHIYAMA T,HIGURASHI T,KURIYAMA H,et al.Oral esomeprazole vs injectable omeprazole for the prevention of hemorrhage after endoscopic submucosal dissection[J].World J Gastrointest Endosc,2017,9(10):514-520.
[3]陈灏珠.实用内科学[M].12版.北京:人民卫生出版社,2005:1838.
[4]ZULLO A,DE FRANCESCO V,VAIRA D.Is double-dose esomeprazole with bismuth really safe?[J].Am J Gastroenterol,2017,112(12):1894-1895.
[5]SHIMOYAMA T,CHINDA D,SAWADA Y,et al.Randomized trial comparing esomeprazole and rabeprazole in first-line eradication therapy for helicobacter pylori infection based on the serum levels of pepsinogens[J].Intern Med,2017,56(13):1621-1627.
[6]MORI H,SUZUKI H,MATSUZAKI J,et al.Antibiotic resistance and gyr A mutation affect the efficacy of 10-day sitafloxacin-metronidazole-esomeprazole therapy for helicobacter pylori in penicillin allergic patients[J].United European Gastroenterol J,2017,5(6):796-804.
[7]骆丹东,傅小玲,吴警伟.消化性溃疡出血患者血清及胃液中白细胞介素的表达与幽门螺杆菌感染关系[J].中华医院感染学杂志,2015,25(6):1242-1244.
[8]HUXFORD K E,DART A J,PERKINS N R,et al.A pilot study comparing the effect of orally administered esomeprazole and omeprazole on gastric fluid pH in horses[J].N Z Vet J,2017,65(6):318-321.
[9]保志军,黄一沁,郑松柏,等.艾司奥美拉唑为基础的三联疗法根除幽门螺杆菌的荟萃分析[J].中国新药与临床杂志,2007,26(1):48-52.