目的 观察伊托必利联合标准三联疗法治疗幽门螺杆菌(Helicobacter pylori,Hp)阳性功能性消化不良(functional dyspepsia,FD)患者症状改善情况及根除Hp效果.方法 Hp阳性的200例FD患者随机分为两组:对照组口服伊托必利(雅培制药有限公司)50m/次,3餐前30min服用.疗程均为14d.实验组给予奥美拉唑20mg、克拉霉素500mg和阿莫西林1000mg口服7d,均2次/d;给予治疗后4周及随访1年后行快速尿素酶试验检测根除Hp效果,并对餐后不适、上腹痛、食欲不振消化不良症状进行评分.结果 治疗后两组患者的症状总积分均较治疗前下降,差异具有统计学意义(P<0.05).在症状改善方面实验组优于对照组(P<0.05).治疗后治疗组胃排空疗效明显优于对照组,差异具有统计学意义(P<0.05).实验组患者Hp根除率为93%(93/100),对照组根除率为8%(8/100),实验组根除率显著高于对照组(P<0.05).结论 伊托必利联合标准三联疗法治疗幽门螺杆菌阳性功能性消化不良可提高治疗FD的疗效,对Hp阳性FD患者Hp根除效果明显好于单用伊托必利组,Hp根除后消化不良症状可显著改善,且安全性好.%Objective To study the effect and facilitate of Itopride combined with standard triple in therapy of Helicobacter pylori - positive functional dyspepsia, and the symptoms improvement and effects of eradication of Hp. Methods 200 cases with Hp positive FD were randomly divided into 2 groups: control group was treated with Itopride for 50mg/time, 30ain before meals. The duration of treatment was 14d. Experimental group were oral administrated with 20mg omeprazole, 500mg elarithromycin and 1000mg amoxicillin for 7d, and 2times/d; Hp eradication effect was detected at the time of 4 weeks and one year after treatment, the postprandial discomfort, upper abdominal pain, loss of appetite, indigestion symptoms were also evaluated. Results After treatment, the total score of symptom was significantly reduced (P ＜ 0.05). The symptom improvement in the experimental group was significantly better than that of the control group (P ＜ 0.05). After treatment, the effect of gastric emptying in experimental group was significantly better than control group (P ＜ 0.05 ). The Hp eradication rate of the experimental group was 93％ (93/100), and was 8％ (8/100) in the control, and the rate in the experimental group was significantly higher than the control (P ＜ 0.05 ). Conclusion Itopride combined with standard triple therapy is safe and efficacy on Helicobacter pylori-positive functional dyspepsia, and the symptom was significantly improved after Hp eradication.
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