CAJ | 학술논문

目的：观察胃铋镁联合雷贝拉唑、克拉霉素、阿莫西林治疗幽门螺杆菌(Hp)阳性十二指肠球部溃疡的临床效果。方法收集2013年10月~2014年10月石狮市医院收治的98例Hp感染阳性的十二指肠球部溃疡患者，将其随机分为治疗组和对照组，各49例。治疗组给予胃铋镁颗粒、雷贝拉唑、克拉霉素、阿莫西林，对照组给予胶体果胶铋、雷贝拉唑、克拉霉素、阿莫西林。两组均口服14 d后，继续口服雷贝拉唑14 d。观察两组患者症状缓解、溃疡愈合及复发、Hp根除率、复发率以及药物不良反应情况。结果治疗组用药第2天消化道症状缓解率(81.63%)明显高于对照组(57.44%)，差异有统计学意义(P<0.05)。治疗组无因不良反应而终止治疗者，对照组2例患者因不良反应终止治疗，治疗组与对照组不良反应发生率分别为6.12%、25.53%，差异有统计学意义(P<0.05)。疗程结束后4周，两组溃疡愈合率和Hp根除率比较差异均无统计学意义(P跃0.05)；疗程结束后半年，治疗组溃疡复发率、Hp复发率低于对照组，但差异无统计学意义(P跃0.05)。结论胃铋镁四联疗法在临床上治疗Hp阳性十二指肠球部溃疡能缓解患者消化道症状，提高患者依从性，减少药物不良反应，降低溃疡复发和Hp再感染的风险，在治疗消化性溃疡上具有一定的优势及较好的安全性。
목적：관찰위필미연합뢰패랍서、극랍매소、아막서림치료유문라간균(Hp)양성십이지장구부궤양적림상효과。방법수집2013년10월~2014년10월석사시의원수치적98례Hp감염양성적십이지장구부궤양환자，장기수궤분위치료조화대조조，각49례。치료조급여위필미과립、뢰패랍서、극랍매소、아막서림，대조조급여효체과효필、뢰패랍서、극랍매소、아막서림。량조균구복14 d후，계속구복뢰패랍서14 d。관찰량조환자증상완해、궤양유합급복발、Hp근제솔、복발솔이급약물불량반응정황。결과치료조용약제2천소화도증상완해솔(81.63%)명현고우대조조(57.44%)，차이유통계학의의(P<0.05)。치료조무인불량반응이종지치료자，대조조2례환자인불량반응종지치료，치료조여대조조불량반응발생솔분별위6.12%、25.53%，차이유통계학의의(P<0.05)。료정결속후4주，량조궤양유합솔화Hp근제솔비교차이균무통계학의의(P약0.05)；료정결속후반년，치료조궤양복발솔、Hp복발솔저우대조조，단차이무통계학의의(P약0.05)。결론위필미사련요법재림상상치료Hp양성십이지장구부궤양능완해환자소화도증상，제고환자의종성，감소약물불량반응，강저궤양복발화Hp재감염적풍험，재치료소화성궤양상구유일정적우세급교호적안전성。
Objective To observe the clinical effect of Compound Bismuth and Magnesium Granules combined with Rabeprazole, Clarithromycin and Amoxicillin for treatment of Hp positive duodenal bulbar ulcer. Methods 98 patients with Hp positive duodenal bulbar ulcer admitted to Shishi Hospital from October 2013 to October 2014 were selected and randomly divided into treatment group and control group, with 49 cases in each group. The treatment group was given Compound Bismuth and Magnesium Granules, Rabeprazole, Clarithromycin, Amoxicillin; the control group was given Colloidal Bismuth Pectin, Rabeprazole, Clarithromycin, Amoxicillin; the two groups were treated with oral admin-istration for 14 days, then with oral Rabeprazole for another 14 days. The remission of symptoms, ulcer healing or re-currence, Hp eradication or recurrence rates, adverse drug reactions of the two groups were observed. Results The sec-ond day when medicine was taken, gastrointestinal symptoms remission rate of the treatment group (81.63%) was signif-icantly higher than that of control group (57.44%) (P<0.05). There were no terminate treatments because of adverse drug reactions in the treatment group, while there were 2 cases in the control group; the incidence of adverse drug re-actions of treatment group and control group was 6.12%, 25.53%respectively, the difference was statistically significant (P < 0.05). Furthermore, 4 weeks after the end of treatment, both ulcer healing and Hp eradication rates of the two groups had no statistically significant differences (P>0.05); and half a year after the end of treatment, the recurrence rates of ulcer and Hp in the treatment group were lower than those of control group, with no statistically significant dif-ferences (P>0.05). Conclusion Compound Bismuth and Magnesium Granules quadruple therapy in the treatment of Hp positive duodenal bulbar ulcer can relieve digestive tract symptoms, improve compliance of patients, reduce adverse drug reactions, decrease the risk of recurrence of peptic ulcer and Hp reinfection, which has a certain advantage and a better safety in the treatment of peptic ulcer.