目的 研究含鉍劑四聯(lián)療法對(duì)胃十二指腸潰瘍患者疼痛癥狀、胃幽門(mén)螺桿菌的影響。方法 選取順義區(qū)空港醫(yī)院內(nèi)科2014年9月-2016年12月收治的120例以疼痛為主要癥狀的胃十二指腸潰瘍患者作為研究對(duì)象。根據(jù)隨機(jī)數(shù)表法分為對(duì)照組60例，于早晚餐后30 min接受口服埃索美拉唑鎂腸溶片，早晚餐后30 min口服阿莫西林膠囊、克拉霉素緩釋片方案治療；研究組60例，在對(duì)照組三聯(lián)療法基礎(chǔ)上加服枸櫞酸鉍鉀膠囊早晚餐前30 min口服。治療2周后繼續(xù)服用4~6周的質(zhì)子泵抑制劑、胃黏膜保護(hù)劑，觀察兩組患者疼痛緩解時(shí)間、胃幽門(mén)螺桿菌根除率，并比較癥狀緩解效果、藥物不良反應(yīng)發(fā)生率。結(jié)果 研究組患者上腹疼痛緩解時(shí)間低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后研究組患者幽門(mén)螺桿菌根除率（91.7%）明顯高于對(duì)照組（76.7%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。研究組患者癥狀緩解總有效率、不良反應(yīng)發(fā)生率與對(duì)照組比較，差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 采用含鉍劑四聯(lián)療法治療胃十二指腸潰瘍效果顯著，安全性高，能減輕患者上腹疼痛癥狀，提高胃幽門(mén)螺桿菌根除效果，促進(jìn)潰瘍愈合，值得臨床推廣應(yīng)用。

Objective To study the influence of bismuth based quadruple therapy on painful symptoms and helicobacter pylori in patients with gastroduodenal ulcer. Methods 120 gastroduodenal ulcer patients with pain as the main syndrome in the internal medicine of Shunyi district Konggang hospital from September 2014 to December 2016 were selected as research object. According to random number table, they were divided intro control group (n=60) which orally took esomeprazole magnesium enteric-coated tablets before meal for 30min, and took amoxicillin capsules, clarithromycin sustained-release tablets after meal for 30 min. Research group (n=60) was given bismuth potassium citrate capsules before meal for 30 min based on control group. After two-week treatment, patients continued to take proton-pump inhibitor and gastric mucosal protective agents for 4 to 6 weeks. The pain alleviation time, eradication rate of helicobacter pylori of two groups were observed. The symptom alleviation effects and the incidence of drug adverse reactions were compared between the two groups. Results The epigastric pain alleviation time in research group was lower than that in control group (P < 0.05). After the treatment, the eradication rate of helicobacter pylori in research group (91.7%) was significantly higher than that in control group (76.7%) (P < 0.05). The total effective rate of symptom alleviation, the incidence of adverse reactions were compared between the two groups, and there was no statistical difference. Conclusion Bismuth based quadruple therapy for gastroduodenal ulcer is effective and has high safety, it can reduce the epigastric pain of patients, increase eradication of helicobacter pylori, promote healing of ulcer, which is worthy of clinical promotion and application.