摘要
目的探讨含奥曲肽方案对幽门螺杆菌(Hp)感染的出血性十二指肠球部溃疡(DU)患者的Hp根除效果,以降低Hp感染率及DU再出血率。方法选取2014年01月至2016年12月132例Hp阳性的出血性十二指肠溃疡住院患者为研究对象,将患者按照不同治疗方案分为标准三联组、铋剂组及奥曲肽组,标准三联组患者口服奥美拉唑、克拉霉素、阿莫西林,铋剂组、奥曲肽组分别在标准三联组方案基础上增加枸橼酸铋钾、奥曲肽,14 d的疗程结束后,各组继续口服奥美拉唑4周,治疗结束后4周复查胃镜检查及H.pylori检测,比较各组患者的Hp根除率、DU愈合率和再出血率。结果 126例患者按方案完成治疗;标准三联组、铋剂组、奥曲肽组ITT根除率分别为72.7%、88.1%和89.1%,PP根除率分别为78.0%、92.5%和91.1%,奥曲肽组和铋剂组的ITT和PP根除率显著高于标准三联组,差异有统计学意义(P <0.05),奥曲肽组和铋剂组间的ITT和PP根除率差异无统计学意义(P> 0.05)。奥曲肽组和铋剂组的DU愈合总有效率显著高于标准三联组,差异有统计学意义(P <0.05),奥曲肽组和铋剂组间的DU愈合率差异无统计学意义(P> 0.05)。标准三联组和铋剂组溃疡再出血率高于奥曲肽组,差异有统计学意义(P <0.05)。标准三联组、铋剂组、奥曲肽组的不良反应发生率分别为14.6%、20%和15.6%,铋剂组显著高于标准三联组和奥曲肽组,但差异无统计学意义(P> 0.05)。结论含奥曲肽方案可以提高十二指肠球部溃疡的Hp根除率,疗效与铋剂四联方案相当,且溃疡再出血率低、不良反应少,适合于消化性溃疡伴出血的住院患者。
Objective To explore the effect of octreotide-containing quadruple regimen on H.pylori eradication in patients with hemorrhagic duodenal ulcer(DU),and to reduce the H.pylori infection rate and rebleeding rate.Methods A total of 132 Hp-infected hemorrhagic DU inpatients were enrolled from Jan.2014 to Dec.2016 in our hospital,and were randomly assigned into standard triple therapy group,bismut group and octreotide group.Patients in standard triple therapy group were given omeprazole,clarithromycin,amoxicillin.Patients in bismuth group and octreotide group were respectively given standard triple therapy combined with bismuth potassium citratecand,octreotide for 14 days.Each groups patients were continued to be given omeprazole for 4 weeks.Gastroscopy andH.pylori examination were given before therapy and after the end of therapy.Finally,eradication rates,ulcer healing rates and DU rebleeding rates in each group would be compared.Results 126 patients completed all treatment.By ITT analysis,the eradication rates of standard triple therapy group,bismuth group and octreotide group were 72.7%,88.1%,89.1%,respectively.For PP analysis,the eradication rates of three groups were 78.0%,92.5%,91.1%,respectively.Eradication rates were analyzed by ITT and PP in octreotide group and bismuth group were significantly higher than those in standard triple therapy group(P<0.05),but no statistically significant difference was found between these two groups(P>0.05).DU healing rates in octreotide group and bismuth group were significantly higher than those in standard triple therapy group(P<0.05),but no statistically significant difference was found between these two groups(P>0.05).DU Rebleeding rates in standard triple therapy group and bismuth group were significantly higher than those in octreotide group(P<0.05).Side effect rate of standard triple therapy group,bismuth group and octreotide group were 8.29%,10%,8.89%,respectively.Side effect rate of bismuth group were significantly higher than those in standard triple therapy group and
作者
程飞
甘厦
郑丽
简捷
CHENG Fei;GAN Xia;ZHENG Li;JIAN Jie(HAU Shenan.Department of Gastroenterology,the Third Affiliated Hospital of Nanchang University,Nanchang 330008,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第18期3097-3100,共4页
The Journal of Practical Medicine
基金
江西省卫生计生委科技计划项目(编号:20167028)
