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[摘要]
目的 研究雷貝拉唑與奧美拉唑四聯(lián)療法治療幽門螺桿菌相關(guān)性消化性潰瘍的療效比較。方法 選取360例幽門螺桿菌相關(guān)性消化性潰瘍患者,隨機(jī)數(shù)字表法分為兩組,雷貝拉唑組患者(180例)給予雷貝拉唑?yàn)榛A(chǔ)的短效四聯(lián)療法,奧美拉唑組患者(180例)給予奧美拉唑?yàn)榛A(chǔ)的短效四聯(lián)療法,均治療14 d。觀察并記錄兩組患者臨床療效、潰瘍愈合率、幽門螺旋桿菌根除率、胃黏膜病理組織學(xué)及治療期間不良反應(yīng)情況。結(jié)果 雷貝拉唑組治愈率(81.7%)明顯高于奧美拉唑組(68.3%),差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療前兩組上腹部疼痛、上腹部不適及噯氣癥狀相比,差異無統(tǒng)計(jì)學(xué)意義。治療后兩組上腹部疼痛、上腹部不適及噯氣患者所占比例降低,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且雷貝拉唑組上腹部疼痛、上腹部不適及噯氣患者所占比例低于奧美拉唑組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,雷貝拉唑組潰瘍愈合率90.6%(163/180),幽門螺桿菌根除率87.8%(158/180),奧美拉唑組潰瘍愈合率70.6%(127/180),幽門螺桿菌根除率72.2%(130/180),雷貝拉唑組潰瘍愈合率和幽門螺桿菌根除率均高于奧美拉唑組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療前,兩組胃黏膜病理組織學(xué)評(píng)分相比,差異無統(tǒng)計(jì)學(xué)意義;治療后,兩組胃黏膜病理組織學(xué)評(píng)分均降低,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05),但組間比較無明顯差異。治療期間,兩組不良反應(yīng)率無明顯差異。結(jié)論 雷貝拉唑短效四聯(lián)療法能顯著治療幽門螺旋桿菌引起的消化性潰瘍,促進(jìn)胃黏膜修復(fù),改善消化性潰瘍臨床癥狀,用藥具有安全性,值得臨床推廣使用。
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[Abstract]
Objective To discuss the clinical application value of omeprazole and rabeprazole quadruple therapy on Helicobacter pylori associated peptic ulcer. Methods 360 patients with Helicobacter pylori associated peptic ulcer were selected. They were divided into two groups randomly. The rabeprazole group (180 cases) was treated with rabeprazole with quadruple therapy based, omeprazole group (180 cases) was treated with omeprazole quadruple therapy of short acting as the foundation, to observe and record the two groups of patients with clinical curative effect, the healing rate of ulcer, Helicobacter pylori eradication rate, histopathology and treatment of gastric mucosa during adverse reaction condition. Results The cure rate of rabeprazole group was significantly higher than that of omeprazole group (P< 0.05).Compared the two groups before treatment, upper abdominal pain, abdominal discomfort, belching symptoms, no significant difference, the two groups after treatment in patients with upper abdominal pain, abdominal discomfort and belching percentage of patients decreased, and Rebela was the proportion of patients with lower group (P<0.05). After treatment, the rabeprazole group of ulcer healing rate 90.5% (163/180), Helicobacter pylori eradication rate was 87.8% (158/180), omeprazole group of ulcer healing rate was 70.5% (127/180), Helicobacter pylori eradication rate was 72.2% (130/180). The rabeprazole group of the healing rate of ulcer and Helicobacter pylori eradication rate were higher (P<0.05). Before treatment, there was no significant difference on gastric mucosal histopathological score between two groups. After treatment, two groups of gastric mucosa pathological score were decreased (P<0.05), no difference between the two groups. During the treatment, there was no significant difference on adverse reactions between two groups. Conclusion Rabeprazole with short acting quadruple therapy can significantly treat Helicobacter pylori causes, promote gastric mucosa repair, improve the clinical symptoms of peptic ulcer, the medication is safe, it is worthy of clinical use.
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