四联疗法治疗幽门螺杆菌阳性胃溃疡的疗效观察

目的：观察埃索美拉唑联合瑞巴派特、阿莫西林、克拉霉素治疗幽门螺杆菌阳性胃溃疡临床疗效。方法：60例确诊的Hp阳性胃溃疡患者随机分为对照组（30例）和治疗组（30例）,其中对照组患者给予奥美拉唑＋阿莫西林＋克拉霉素三联法治疗,实验组给予埃索美拉唑＋瑞巴派特＋阿莫西林＋克拉霉素四联法治疗。观察比较两组患者临床症状缓解情况,溃疡愈合率、Hp根除率及溃疡复发率。结果：①经过治疗,所有患者腹痛、腹胀、反酸、暧气等临床症状积分均显著降低（P〈0.01）,且治疗组下降程度大于对照组,两组间差异有统计学意义（P〈0.05）。②治疗组患者痊愈率为60.00%、总有效率为93.33%,明显高于对照组痊愈率（43.33%）和总有效率（80.00%）,两组间差异有统计学意义（P〈0.05）。③治疗组S2期获得率、溃疡愈合率和Hp根除率分别为93.33%、96.67%和93.33%,显著高于对照组60.00%的S2期获得率、70.00%的愈合率和83.33%的根除率（P〈0.01或0.05）。④随访1年后,治疗组患者溃疡复发率为11.54%,与对照组32.00%的复发率比较差异有显著性（P〈0.05）。结论：四联疗法治疗幽门螺杆菌阳性胃溃疡可有效缓解患者临床症状,提高溃疡愈合质量,根除Hp感染,减少复发,效果优于三联疗法。

Observation on curative effect of quadruple therapy in Helicobacter pylori-positive gastric ulcer

Objective：To observe the clinical effect of esomeprazole combined with rebamipide,amoxicillin and clarithromycin on positive pylorus spirillum gastric ulcer.Methods：60 patients with Helicobacter pylori-positive gastric ulcer were divided randomly into control group（30 cases） and treatment group（30 cases）.In the control group,patients were treated with omeprazole,amoxicillin and clar-ithromycin.The treatment group was treated with esomeprazole,rebamipide,amoxicillin and clarithromycin.The change of symptoms,clinical remission rate,ulcer healing rate,Hp eradication rate and ulcer recurrence rate were analyzed between the two groups.Results：①After treatment,the clinical symptom score of abdominal pain,epigastric distention,sour regurgitation and belching significantly de-creased in all patients,especially in treatment group（P0.01 or 0.05）.② The cure rate and total effective rate were 60.00% and 93.33% respectively in treatment group,which were significantly higher than 43.33% and 80.00% in the control group（P0.05）.③ The stage S2 achievement rate,ulcer healing rate and eradication rate of HP were 93.33%,96.67% and 93.33% in treatment group,which were respec-tively 60.00%,70.00% and 83.33% in control group,and there was significant difference between the two groups（P0.01 or 0.05）.④ At the end of 1 year follow-up,the ulcer recurrence rate were 11.54% and 32.00% in treatment and control group respectively,and there was significant difference between the two groups（P0.05）.Conclusion：Quadruple therapy of Hp-positive gastric ulcer could relieve the clin-ical symptom of patients,improve the quality of ulcer healing,eradicate Hp,and prevent reoccurrence,which is better than triple therapy.