三联疗法对消化性溃疡胃黏膜抗炎及抑制Hp感染的临床研究

目的客观评价三联疗法对消化性溃疡患者胃黏膜抗炎及抑制幽门螺杆菌Hp感染的作用。方法选择2007年1月-2009年12月于我院门诊及住院收治的Hp相关性消化性溃疡患者148例,分为实验组与对照组各74例,实验组采用埃索美拉唑、克拉霉素、阿莫西林三联疗法治疗,对照组仅给予埃索美拉唑治疗,疗程均2周。两组患者均于治疗前及疗程结束后4周进行电子胃镜检查、组织病理学及Hp检测,并随访两组患者治疗过程中的不良反应。结果三联疗法治疗患者溃疡愈合率明显高于单用埃索美拉唑治疗,且三联疗法能有效地清除和减轻溃疡灶周围粘膜炎症,其疗效明显优于单用埃索美拉唑治疗（P〈0.05）。对根除Hp感染的疗效也明显优于单用埃索美拉唑治疗的对照组（P〈0.05）。两组患者治疗过程中均未发现明显肝、肾功能损害,均能耐受继续治疗,且两组不良反应发生率差异无统计学意义（P〉0.05）。结论埃索美拉唑、克拉霉素、阿莫西林三联治疗方案能有效地根除Hp和减轻胃粘膜炎症,有助于溃疡愈合。

Clinical Effect of Triple Therapy on Treatment of Gastric Mucosa Inflammation and Suppression of Hp Infection in Patients with Peptic Ulcer

Objective To objectively evaluate the efficacy of triple-therapy regimens in the treatment of peptic ulcer.Methods A total of 148 patients with Hp-related peptic ulcer disease in the Huaian First Affiliated Hospital of Nanjing Medical University from January,2007 to December,2009 were chosen and randomly divided into two groups （each n=74）.The experimental group was treated with triple-therapy regimens,while the control group was given esomeprazole only.The patients in the two groups were treated for 2 weeks.All the patients underwent gastroscopy before the treatment and 4 weeks after therapy,meanwhile histopathological examination and Hp determination were done.The side effects of the two groups during the treatment were followed up.Results The ulcer healing rate in the experimental group was significantly higher than that in the control group.The effect on reducing the inflammation of the gastric mucosa and suppressing the infection of Hp in the experimental group was better than that in the control group （P〈0.05）.The therapeutic effect of eradicating Hp infection in the experimental group was significantly superior to that in the control group （P〈0.05）.No live and kidney damage was found in the patients of the two groups during the treatment.All the patients were well tolerant during the treatment.And no statistically significant difference was found in the incidence rate of side effects between the two groups （P〉0.05）.Conclusions Triple-therapy regimens are better in reducing the inflammation of the gastric mucosa and suppressing the infection of Hp.The therapy has the function of promoting the healing of peptic ulcer.