目的 探讨四联疗法联合口腔洁治根除消化性溃疡合并幽门螺杆菌(helicobacter pylori,Hp)感染初治者的疗效.方法 246例合并胃及口腔Hp感染初治消化性溃疡者采用随机数字表法随机分入对照组和试验组.对照组123例患者予泮托拉唑+胶体果胶铋+克拉霉素+阿莫西林四联疗法治疗;试验组123例患者在对照组基础上另外给予口腔洁治处理.两组患者均完成2周药物治疗.治疗结束后4周对两组患者胃及口腔Hp根除情况进行评估.治疗结束后随访1年,评估两组患者胃及口腔Hp感染复发率.结果 治疗结束4周时,试验组和对照组胃Hp根除率分别为91.06%和78.86%,差异有统计学意义(P<0.05).试验组口腔Hp根除率分67.48%高于对照组44.72%(P<0.05).随访结束时,试验组和对照组胃Hp感染复发率分别为24.11%和40.21%,差异有统计学意义(P<0.05).试验组口腔Hp感染复发率41.96%低于对照组74.23%(P<0.05).结论 口腔洁治可提高四联疗法根除消化性溃疡患者胃和口腔Hp的临床疗效,减少胃和口腔Hp感染复发率.%Objective To investigate the efficacy of the quadruple therapy combined with oral scaling in eradicating the helicobacter pylori (Hp)infection in patients with peptic ulcer.Methods 246 patients with peptic ulcer complicated with the gastric and oral Hp infection were divided into the experiment group and control group according to the random number table and each group consisted of 123 cases.The control group was given the quadruple therapy with pantoprazole,bismuth pectin,clarithromycin and amoxicillin,while the experiment group was treated with the same quadruple therapy combined with oral scaling.The patients of both groups were treated for 2 weeks and the eradication rates of the gastric and oral Hp infection were assessed 4 weeks after treatment.The patients of both groups were followed up for 1 year to assess the reinfection rate.Results The eradication rates of gastric and oral Hp infection in the experiment group were 91.06% and 67.48% respectively and those in the control group were 78.86% and 44.72% respectively,and the differences were statistically different(P < 0.05 ). The reinfection rates of gastric and oral Hp infection in the experiment group were 24.11% and 41.96% respectively and those in the control group were 40.21% and 74.23 respectively,and the differences were statistically different (P <0.05).Conclusion The oral scaling can improve the efficacy of the quadruple therapy in eradicating the oral and gastric Hp infection and reduce the oral and gastric Hp reinfection in patients with peptic ulcer.
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