摘要
目的探讨不同抗菌药物对幽门螺杆菌(Hp)感染合并消化性溃疡的治疗效果及对微生物菌群的影响。方法选取2021年1月至2022年10月葫芦岛市中心医院收治的400例Hp感染合并消化性溃疡患者作为研究对象,采用随机数字表法将其分为A、B、C、D组,每组100例。所有患者均采用抗菌药物+艾司奥美拉唑+枸橼酸铋钾治疗,其中A组患者予以左氧氟沙星+呋喃唑酮,B组患者予以甲硝唑+阿莫西林,C组患者予以阿莫西林+呋喃唑酮,D组应用克拉霉素+阿莫西林。比较4组患者临床疗效、炎症因子水平、肠道微生物菌群变化、不良反应及Hp清除率。结果D组治疗有效率高于A、B、C组(P<0.05),但A、B、C组治疗有效率比较差异无统计学意义(P>0.05)。治疗后4组患者白细胞介素-2(IL-2)水平升高,D组高于A、B、C组,C组高于A、B组,C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平降低,D组低于A、B、C组,C组低于A、B组,差异有统计学意义(P<0.05),但A、B组比较差异无统计学意义(P>0.05)。治疗后4组患者乳酸杆菌、双歧杆菌以及类杆菌水平升高,D组高于A、B、C组,C组高于A、B组,大肠杆菌及粪肠球菌水平降低,D组低于A、B、C组,C组低于A、B组,差异有统计学意义(P<0.05),但A、B组比较差异无统计学意义(P>0.05)。4组均无严重不良反应发生,A、C、D组不良反应发生率比较差异无统计学意义(P>0.05),但B组不良反应发生率高于A、C、D组(P<0.05);D组Hp清除率高于A、B、C组(P<0.05),但A、B、C组比较差异无统计学意义(P>0.05)。结论Hp感染合并消化性溃疡采用两种抗生素+艾司奥美拉唑+枸橼酸铋钾治疗具有一定临床疗效,但应用克拉霉素+阿莫西林作为抗菌药物进行治疗疗效更显著,能够有效降低患者炎症因子水平,改善肠道菌群结构,提升Hp清除率,且安全性较高。
Objective To explore the therapeutic effect of different antibiotics on Helicobacter pylori infection complicated with peptic ulcer and the influence on microflora.Methods A total of 400 patients with Hp infection combined with peptic ulcer admitted to Huludao Central Hospital from January 2021 to October 2022 were selected as the study objects,and were divided into groups A,B,C and D with 100 cases in each group by random number table method.All patients were treated with antibiotics+esomeprazole+bismuth potassium citrate,among which group A was given levofloxacin+furazolidone,group B was given metronidazole+amoxicillin,group C was given amoxicillin+furazolidone,and group D was given clarithromycin+amoxicillin.The clinical efficacy,levels of inflammatory factors,changes of intestinal microflora,adverse reactions and Hp clearance in 4 groups were compared.Results The therapeutic effective rate of group D was higher than that of groups A,B and C(P<0.05),but there was no significant difference in the therapeutic effective rate of group A,B and C(P>0.05).After treatment,the level of interleukin-2(IL-2)in 4 groups was increased,group D was higher than groups A,B and C,group C was higher than groups A and B,C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)levels were decreased,group D was lower than groups A,B and C,and group C was lower than groups A and B,the difference was statistically significant(P<0.05).There was no significant difference between group A and group B(P>0.05).After treatment,the levels of lactobacillus,bifidobacterium and bacterioid bacteria in 4 groups were increased,group D was higher than groups A,B and C,group C was higher than groups A and B,and the levels of Escherichia coli and Enterococcus faecalis were decreased,group D was lower than groups A,B and C,and group C was lower than groups A and B,with statistical significance(P<0.05).There was no significant difference between group A and group B(P>0.05).No serious adverse reactions occurred in the 4 groups,and there was no signific
作者
陈超
CHEN Chao(Department of Gastroenterology,Huludao Central Hospital,Huludao 125000,China)
出处
《中国药物经济学》
2023年第11期77-81,85,共6页
China Journal of Pharmaceutical Economics
