铝碳酸镁、兰索拉唑、阿莫西林、呋喃唑酮四联疗法治疗幽门螺杆菌相关性胃溃疡的效果及安全性评价

目的观察铝碳酸镁、兰索拉唑、阿莫西林、呋喃唑酮四联疗法治疗幽门螺杆菌相关性胃溃疡的效果及安全性。方法2016年3月至2017年12月开滦总医院林西医院消化科收治的符合纳入标准的幽门螺杆菌相关性胃溃疡患者120例作为观察对象。采用随机数字表法将其分为观察组和对照组,每组60例。对照组给予兰索拉唑+阿莫西林+呋喃唑酮三联治疗。观察组在此基础上加用铝碳酸镁。比较两组患者治疗后的临床疗效,幽门螺杆菌清除率,胃液血管内皮生长因子(vascular endothelial growth factor,VEGF)和表皮细胞生长因子(epidermal growth factor,EGF)水平的差异,以及治疗期间患者的不良反应。结果观察组临床总有效率95.0%(57/60)显著优于对照组的83.3%(50/60),两组比较差异有统计学意义(χ^2=4.23,P<0.05)。两组患者综合症状评分均随治疗时间的推移显著下降[观察组治疗前(9.6±2.2)分、治疗2周(5.5±1.5)分、治疗4周(4.3±1.2)分、治疗6周(3.1±0.8)分,对照组治疗前(9.4±2.5)分、治疗2周(7.2±1.3)分、治疗4周(6.6±1.4)分、治疗6周(4.5±1.0)分],且观察组综合症状评分下降幅度显著大于对照组,差异有统计学意义(F组间=23.54,P<0.05;F组内=87.62,P<0.05;F交互=8.47,P<0.05)。两组患者治疗后胃液VEGF水平显著升高,观察组(429.4±128.5)ng/L显著高于对照组(380.3±137.2)ng/L(t=2.02,P<0.05)。两组患者治疗后胃液EGF水平显著升高,观察组(658.1±164.0)ng/L显著高于对照组(583.5±135.1)ng/L(t=2.72,P<0.05)。两组患者不良反应发生率[观察组6.7%(4/60)、对照组8.3%(5/60)]比较,差异无统计学意义(χ^2=0.12,P>0.05)。结论铝碳酸镁、兰索拉唑、阿莫西林、呋喃唑酮四联方案治疗幽门螺杆菌相关性胃溃疡能够明显改善患者的临床症状,促进溃疡黏膜的再生。

Efficacy and safety evaluation of magnesium aluminate,lansoprazole,amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer

Objective To investigate the efficacy and safety of magnesium aluminium carbonate,lansoprazole,amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer.Methods From March 2016 to December 2017,120 patients with HP related gastric ulcer who met the inclusion criteria were enrolled in the digestive department of Linxi Hospital of Kailuan general hospital.They were divided into observation group and control group with random number table method,60 cases in each group.The control group was given lansoprazole+amoxicillin+furazolidone triple therapy.On this basis,the observation group was added with magnesium aluminum carbonate.The clinical efficacy,clearance rate of Helicobacter pylori,the level of VEGF and EGF in gastric juice were compared between the two groups.Results The total clinical effective rate of the observation group was 95.0%(57/60),which was significantly higher than that of the control group(83.3%)(50/60).The difference between the two groups was statistically significant(χ^2=4.23,P<0.05).The comprehensive symptom scores of the two groups decreased significantly with the treatment time(observation group:before treatment(9.6±2.2),treatment 2 weeks(5.5±1.5),treatment 4 weeks(4.3±1.2),treatment 6 weeks(3.1±0.8),control group(9.4±2.5),treatment 2 weeks(7.2±1.3),treatment 4 weeks(6.6±1.4),treatment 6 weeks(4.5±1.0)),and observation group syndrome scores There was significant difference between the two groups(Finter-group=23.54,Pinter-group<0.05;Fintra-group=87.62,Pintra-group<0.05;Finteraction=8.47,Pinteraction<0.05).After treatment,VEGF level in gastric juice of the two groups increased significantly after treatment.In the observation group((429.4±128.5)pg/ml)was significantly higher than that in the control group((380.3±137.2)pg/ml,t=2.02,P<0.05).The EGF level in gastric juice of the two groups increased significantly after treatment.In the observation group((658.1±164.0)pg/ml)was significantly higher than that in the control group((583.5±135.1)pg/ml,t=2.72,P<0.05).The incidence of adverse reactions was 6.7%(4/60)in the observation group and 8.3%(5/60)in the control group.There was no significant difference(χ^2=0.12,P>0.05).Conclusion The treatment of Helicobacter pylori related gastric ulcer with the combination of aluminum carbonate,lansoprazole,amoxicillin and furazolidone can obviously improve the clinical symptoms and promote the regeneration of ulcer mucosa.