张静洁等

[摘要] 目的 观察胃铋镁颗粒联合标准三联疗法根除幽门螺旋杆菌（Hp）的临床疗效。 方法 选择2012年12月～2014年10月包头医学院第二附属医院经13C-尿素呼气试验确诊的424例Hp感染患者为研究对象，并将其分为观察组（220例）和对照组（204例）。观察组给予胃铋镁颗粒及三联疗法（埃索美拉唑、克拉霉素、阿莫西林）10 d，并继续服用胃铋镁颗粒及埃索美拉唑至1个月；对照组给予三联疗法，疗程同观察组。停药后4周复查13C-尿素呼气试验，回顾性分析比较两组Hp根除效果及不良反应发生率。 结果 观察组Hp根除率（91.8%）高于对照组（78.4%），差异有统计学意义（P < 0.05）。观察组和对照组的不良反应发生率分别为12.7%、13.7%，差异无统计学意义（P > 0.05），两组均未见严重不良反应。 结论 胃铋镁四联疗法对于根治幽门螺旋杆菌效果更突出，优于标准三联疗法，且安全性接近，值得临床推广。

[关键词] 幽门螺旋杆菌；胃铋镁颗粒；四联疗法；三联疗法

[中图分类号] R573 [文献标识码] A [文章编号] 1673-7210（2015）05（c）-0136-04

[Abstract] Objective To observe curative effect of Compound Bismuth and Magnesium Granules combined with standard triple therapy in eradication of Helicobacter pylori （Hp）. Methods 424 Hp infected patients confirmed by 13C-urea breath test in the Second Affiliated Hospital of Baotou Medical College from December 2012 to October 2014 were selected as study objects， and they were divided into observation group （n = 220） and control group （n = 204）. The observation group was given Compound Bismuth and Magnesium Granules and triple therapy （Esomeprazole， Clarithromycin， Amoxicillin） for 10 d， and then they were given Compound Bismuth and Magnesium Granules and Esomeprazole until one month. The control group was given triple therapy for the same treatment course as the observation group. After treatment for 4 weeks， all of the patients were reviewed by 13C-urea breath test. The Hp eradication rate and the incidence of ADR were compared between 2 groups by retrospective analysis. Results The Hp eradication rate of the observation group （91.8%） was higher than that of control group （78.4%）， with a statistical significance （P < 0.05）. The incidence of ADR of the observation group and the control group was 12.7% and 13.7% respectively， with no statistical significance （P > 0.05）， serious ADR were rarely seen in the two groups. Conclusion Compared with standard triple therapy， Compound Bismuth and Magnesium Granules quadruple therapy has similar security but higher efficacy of Hp eradication. So， it is worthy of clinical promotion.

[Key words] Helicobacter pylori； Compound Bismuth and Magnesium Granules； Quadruple therapy； Triple therapy

幽门螺旋杆菌（Hp）是一种微需氧的革兰阴性螺旋菌，相关研究表明[1]，Hp与消化性溃疡、胃癌、慢性胃炎、胃黏膜相关淋巴组织（MALT）淋巴瘤等疾病存在着紧密的相关性，甚至可导致不明原因的缺铁性贫血、特发性血小板减少性紫癜、慢性荨麻疹、糖尿病等。临床主要采用含质子泵抑制剂（PPI）三联疗法治疗，然而近年来随着耐药性的上升，使用药物是否不断增加和药物的副作用影响值得研究与探讨。本研究回顾性总结包头医学院第二附属医院（以下简称“我院”）消化科经13C-尿素呼气试验确诊的424例Hp感染患者的Hp根治方案，对比不同方案的疗效及药物副作用，以便于寻找根除Hp的最佳方案。……