牙周干预联合常规四联药物治疗对口腔及胃幽门螺杆菌根除效果的临床研究

探讨牙周干预联合常规四联药物对口腔及胃部幽门螺杆菌根除的效果, 为该类患者的治疗提供参考。

选择胃部H.pylori阳性转诊口腔科进行牙周健康状况及口腔H.pylori检查的患者140例, 随机分为观察组和对照组各70例。对照组患者采用常规四联药物治疗, 观察组在对照组的用药基础上给予牙周干预治疗。对比两组患者治疗前及停药1个月、6个月及12个月后的牙周临床指数和胃肠道症状; 记录并比较两组患者停药1个月、6个月及12个月后口腔H.pylori根除率和胃H.pylori根除率, 评估两组患者治疗不良反应。

停药1个月、6个月及12个月后, 两组患者牙周临床指数中GI、SBI、PD及CAL值和胃肠道症状评分(腹痛腹胀、恶心呕吐、反酸嗳气)较治疗前显著降低, 同时观察组患者均显著低于对照组(均P < 0.05)。观察组患者停药6个月及12个月后口腔H.pylori根除率和胃H.pylori根除率均显著高于对照组(81.43%vs 60.00%, 71.43%vs 48.57%, 75.71%vs 51.43%, 68.57%vs 41.43%;χ²=7.761、7.619、8.914、10.418, 均P < 0.05)。观察组和对照组患者的不良反应总发生率对比差异无统计学意义(4.29%vs 2.86%, P > 0.05)。

牙周干预联合常规四联药物能显著改善胃部H.pylori感染患者的牙周组织健康状况, 减轻其胃肠道症状, 并能有效降低其口腔H.pylori根除率和胃H.pylori根除率, 安全性良好。

Clinical study on effect of periodontal intervention combined with conventional quadruple therapy on the eradication of oral and gastric Helicobacter pylori

ObjectiveTo explore the effect of periodontal intervention combined with conventional quadruple therapy on the eradication of oral and gastric Helicobacter pylori(H.pylori), and provide reference for the treatment of such patients.MethodsA total of 140 patients with positive gastric H.pylori infection who were referred to department of stomatology for periodontal health examination and oral H.pylori examination were selected and randomly divided into observation group or control group, 70 cases in each group. The control group was treated with conventional quadruple therapy, while the observation group was additionally given periodontal intervention on the basis of medication in the control group. The periodontal clinical indexes and gastrointestinal symptoms were compared between the two groups before treatment and after 1 month, 6 months and 12 months of drug withdrawal, and the eradication rates of oral and gastric H.pylori in the two groups were recorded and compared after 1 month, 6 months and 12 months of drug withdrawal. The adverse reactions of treatment were evaluated in both groups.ResultsAfter 1 month, 6 months and 12 months of drug withdrawal, the periodontal clinical indexes GI, SBI, PD and CAL and scores of gastrointestinal symptoms(abdominal pain and abdominal distention, nausea and vomiting, acid reflux and belching) in the two groups significantly decreased compared with those before treatment, and the above indexes and scores in observation group were significantly lower than those in control group(all P < 0.05). The eradication rates of oral and gastric H.pylori in observation group after 6 and 12 months of drug withdrawal were significantly higher in observation group than those in control group(81.43% vs 60.00%, 71.43% vs 48.57%, 75.71% vs 51.43%, 68.57% vs 41.43%; χ2=7.761, 7.619, 8.914, 10.418, all P < 0.05). There was no statistically significant difference in the total incidence rate of adverse reactions between observation group and control group(4.29% vs 2.86%, P > 0.05).ConclusionPeriodontal intervention combined with conventional quadruple therapy can significantly improve the periodontal tissue health of patients with gastric H.pylori infection, reduce the gastrointestinal symptoms, and effectively lower the eradication rates of oral and gastric H.pylori, with good safety.