埃索美拉唑联合抗生素治疗幽门螺杆菌阳性萎缩性胃炎的临床研究

目的观察埃索美拉唑联合阿莫西林克拉维酸钾及左氧氟沙星对幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的临床疗效。方法 Hp阳性慢性萎缩性胃炎伴异型增生患者400例随机分为治疗组300例和对照组100例,治疗组给予埃索美拉唑40 mg,每天1次;阿莫西林克拉维酸钾片375 mg,每天2次;左氧氟沙星片100 mg,每天2次,均口服;对照组给予奥美拉唑肠溶胶囊20 mg,每天2次;阿莫西林胶囊1.0 g,每天2次;克拉霉素片0.25 g,每天2次,均口服。2组均治疗2周。60 d后行胃镜及组织学复查。结果消化道症状改善:治疗组总有效率为95.0%,高于对照组的72.0%(P<0.05);组织学观察:治疗组总有效率为94.0%,高于对照组的25.0%(P<0.01)。治疗组治疗后除纳差、嗳气、恶心外,其余各项评分均较对照组相应指标变化显著(P<0.05或P<0.01)。治疗组Hp转阴率为94.7%,高于对照组的71.0%(P<0.05)。2组不良反应比较差异无统计学意义(P>0.05)。结论埃索美拉唑联合阿莫西林克拉维酸钾及左氧氟沙星可以提高Hp根除率,且对CAG伴异型增生的逆转疗效显著。

Clinical study of esomeprazole combined treatment on chronic atrophic gastritis with helicobacter pylori positive

Objective To investigate and study the clinical effect of esomeprazole combined with amoxicillin and clavulanate potassium and levofloxacin on helicobacter pylori （Hp） eradication and reversion of chronic atrophic gastritis （CAG） with dysplasia. Methods 400 cases of Hp positive patients with CAG and hyperplasia were randomly divided into treatment group （300 cases） and control group （ 100 cases）, the treatment group was given esomeprazole 40 rag, once a day; amoxicillin clavulanic potassium 375 rag, twice a day; levofloxacin 100 rag, twice a day, orally; Control group was given omeprazole enteric capsules 20 rag, twice a day; amoxicillin capsule 1.0 g, twice a day; Clarithromycin tablet 0.25g, twice a day, orally. Two groups were both treated for 2 weeks. 60 days later, gastroscope and histological result was reviewed. Results The digestive tract symptoms improvement, the total effective rate of the treatment group was 95.0%, the total effective rate of the control group was 72.0%, comparing two groups, there was significant difference （ P 〈 0. 05 ） ; Histological observation, total effectiveness of the treatment group was 94.0%, that of the control group was 25.0%, comparing two groups, there was significant differences （ P 〈 0.01 ）. In the treatment group after treatment, except no appetite, belching, nausea, the rest of the corresponding index were changed more significantly than those of the control group （ P 〈 0.05 or P 〈 0.01 ）. The negative conversation ratio of treatment group was 94.7%, which of the control group was 71.0%, comparing two groups; the difference was statistically significant （ P 〈 0.05）. Comparing adverse reaction of two groups, there was no significant difference （P 〉 0.05 ）. Conclusion The curative effect of esomeprazole combined with amoxicillin and clavulanate potassium and levofloxacin on helicobacter pylori eradication and reversion of CAG with dysplasia is remarkable.