CAJ | 학술논문

目的:评估抗幽门螺杆菌(Helicobacter pylori,HP)治疗及联合常规止吐药物对肿瘤患者化疗所致胃肠道不良反应的疗效.方法:2010年1月至2011年1月,共纳入176例患者,其中伴有幽门螺杆菌感染患者86例.将HP感染阳性者随机分为A组和B组.A组43例给予抗幽门螺杆菌联合止吐药物(奥美拉唑20 mg+克拉霉素500 mg+替硝唑500 mg,2次/d,口服7 d;联合托烷司琼5 mg,静脉滴注,1次/d;疗程共4周)治疗,B 组43例仅给予止吐药物(托烷司琼5mg,疗程共4周)治疗,两组患者在性别、年龄、临床表现无差别.应用WHO胃肠道反应分度标准进行观测和评价,应用14C-尿素呼气试验评估幽门螺杆菌根除率.结果:接受化疗并伴有幽门螺杆菌感染的患者呕吐程度比未感染者严重,其中Ⅲ~Ⅳ度呕吐(χ2=21.92,P<0.001),Ⅰ~Ⅱ度呕吐(χ2=9.73, P<0.01)差异均有统计学意义.联合抗菌治疗患者的恶心、呕吐等症状比常规止吐患者减轻,A组治疗恶心、呕吐的总有效率为81.39%(35/43),明显高于B组的58.14%(25/43),差异有统计学意义(χ2=4.46,P<0.05).结论:针对幽门螺杆菌阳性患者给予抗幽门螺杆菌联合常规止吐治疗,可以有效减轻和缓解化疗所致的胃肠道不良反应.
목적:평고항유문라간균(Helicobacter pylori,HP)치료급연합상규지토약물대종류환자화료소치위장도불량반응적료효.방법:2010년1월지2011년1월,공납입176례환자,기중반유유문라간균감염환자86례.장HP감염양성자수궤분위A조화B조.A조43례급여항유문라간균연합지토약물(오미랍서20 mg+극랍매소500 mg+체초서500 mg,2차/d,구복7 d;연합탁완사경5 mg,정맥적주,1차/d;료정공4주)치료,B 조43례부급여지토약물(탁완사경5mg,료정공4주)치료,량조환자재성별、년령、림상표현무차별.응용WHO위장도반응분도표준진행관측화평개,응용14C-뇨소호기시험평고유문라간균근제솔.결과:접수화료병반유유문라간균감염적환자구토정도비미감염자엄중,기중Ⅲ~Ⅳ도구토(χ2=21.92,P<0.001),Ⅰ~Ⅱ도구토(χ2=9.73, P<0.01)차이균유통계학의의.연합항균치료환자적악심、구토등증상비상규지토환자감경,A조치료악심、구토적총유효솔위81.39%(35/43),명현고우B조적58.14%(25/43),차이유통계학의의(χ2=4.46,P<0.05).결론:침대유문라간균양성환자급여항유문라간균연합상규지토치료,가이유효감경화완해화료소치적위장도불량반응.
Objective: This work aims to assess the effects of anti-Helicobacter pylori (anti-H. pylori) therapy combined with antiemetic drugs on chemotherapy-induced gastrointestinal toxicity. Methods: Out of the 176 patients who were enrolled in the research from January 2010 to January 2011, 86 were infected by H. pylori. Infected patients were randomly divided into Groups A and B. Patients in Group A (n=43) received anti-H. pylori therapy combined with antiemetic drugs (20 mg omeprazole, 500 mg clarithromycin, and 500 mg tinidazole, twice a day, plus 5 mg tropisetron, for four weeks). Patients in Group B (n=43) only received antiemetic drugs (5 mg tropisetron for four weeks). No statistical significance was observed between Groups A and B for gender, age, and clinical manifestations. Clinical symptoms were observed and evaluated based on the gastrointestinal reaction indexing standards of the World Health Organization. The H. pylori eradication rate was assessed by 4C-urea breath test. Results: The vomiting severity was higher in the patients who were infected by H. pylori and subsequently underwent chemotherapy compared with the non-infected patients. Significant differences were observed between grades Ⅲand Ⅳ vomiting (χ2=21.92, P<0.001), as well as between grades I and II vomiting (χ2=9.73, P<0.01). The degree of nausea and vomiting was reduced in the patients who underwent anti-H. pylori therapy combined with antiemetic drugs, compared with those who only received antiemetic drugs. The total efficiency of the treatment was significantly higher in group A than in group B (χ2=4.46, P<0.05). Conclusion:Anti-H. pylori treatment combined with antiemetic drugs may effectively reduce and relieve chemotherapy-induced gastrointestinal toxicity for patients infected with H. pylori.