3种用药方案治疗幽门螺杆菌感染活动性慢性胃炎的临床观察

摘要

目的：观察3种用药方案治疗幽门螺杆菌（Hp）感染活动性慢性胃炎的Hp根除情况和安全性。方法：150例Hp感染活动性慢性胃炎患者随机分为A组（50例）、B组（50例）和C组（50例）。A组患者给予奥美拉唑肠溶胶囊20 mg，口服，每日2次+阿莫西林胶囊1.0 g，口服，每日3次+克拉霉素片0.5 g，口服，每日1次。B组患者在A组治疗的基础上给予胶体果胶铋胶囊150 mg，口服，每日3次。C组患者第1～5天给予奥美拉唑肠溶胶囊20 mg，口服，每日2次+阿莫西林胶囊1.0 g，口服，每日3次，第6～10天给予奥美拉唑肠溶胶囊20 mg，口服，每日2次+克拉霉素片0.5 g，口服，每日1次+甲硝唑片0.4 g，每日2次。各组患者疗程均为10 d。观察各组患者疼痛缓解有效率、疼痛缓解时间、消化道症状缓解时间、Hp根除率、随访12个月的复发情况及不良反应发生情况。结果：疼痛缓解有效率、Hp根除率C组＞B组＞A组，疼痛缓解时间、消化道症状缓解时间、复发率C组＜B组＜A组，差异均有统计学意义（P＜0.05）。不良反应发生率C组＜A、B组，差异均有统计学意义（P＜0.05），但A、B组间比较差异无统计学意义（P＞0.05）。结论：分阶段服用奥美拉唑联合抗菌药物治疗Hp感染活动性慢性胃炎可有效缓解患者胃部疼痛，缩短病程，提高Hp根除率，降低远期复发率，且安全性较好。%OBJECTIVE:To observe the Hp eradication situation and safety of three kinds of drug regimen in the treatment of active chronic gastritis with helicobacter pykori(Hp)infection. METHODS:150 active chronic gastritis patients with Hp infection were randomly divided into group A(50 cases),group B(50 cases)and group C(50 cases). Group A received Omeprazole enter-ic-coated capsule 20 mg,orally,twice a day+Amoxycillin capsules 1.0 g,orally,3 times a day+Clarithromycin tablet 0.5 g,oral-ly,once a day. Group B additionally received Colloidal bismuth pectin capsule 150 mg,orally,3 times a day. Group C received Omeprazole enteric-coated capsule 20 mg,orally,twice a day+Amoxycillin capsules 1.0 g,orally,3 times a day,1-5 d,Omepra-zole enteric-coated capsule 20 mg,orally,twice a day+ Clarithromycin tablets 0.5 g,orally,once a day+Metronidazole tablet 0.4 g,twice a day,6-10 d. All patients treated for 10 d. Effective rate of pain relief,relief time of pain and gastrointestinal symptoms, Hp eradication rate,recurrence after 12 follow-up and the incidence of adverse reactions in all groups were observed. RESULTS:Effective rate of pain relief and Hp eradication rate in group C were higher than group B,followed by group A,relief time of pain and gastrointestinal symptoms,recurrence rate in group C were lower than group B,which was lower than group A,with signifi-cant differences (P0.05). CONCLUSIONS:Taking omeprazole in stages combined with antibiotics can effectively relieve abdominal pains,shorten disease course,improve Hp eradica-tion rate,reduce long-term recurrence rate in the treatment of active chronic gastritis with Hp infection,with good safety.