赵兰敏+石振东

[摘要]目的 对比观察艾普拉唑、枸橼酸铋钾联合两种抗生素治疗幽门螺杆菌（Hp）相关性慢性胃炎的1周及2周效果。方法 选择2013年1月～2015年6月本院收治的156例Hp相关性慢性胃炎患者，采用随机数字表法将其分为A组（78例）和B组（78例），均给予艾普拉唑5 mg、枸橼酸铋钾0.6 g、阿莫西林1.0 g及左氧氟沙星0.2 g治疗，均为2次/d，A、B组分别治疗1周和2周，比较两组的临床效果、Hp根除率及不良反应情况。结果 A、B组总有效率分别为93.6%、94.9%，差异无统计学意义（P>0.05）。但B组Hp根除率（89.7%）明显高于A组的75.6%，差异有统计学意义（P<0.05）。A、B组不良反应发生率分别为6.4%、9.0%，差异无统计学意义（P>0.05）。结论 艾普拉唑、枸橼酸铋钾联合两种抗生素2周疗程治愈率及Hp根除率均明显优于1周疗程，并且不良反应相近。

[关键词]幽门螺杆菌；根除治疗；联合疗法；慢性胃炎

[中图分类号] R573.3 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0045-03

[Abstract]Objective To observe the curative effect of one week therapeutic course and two weeks therapeutic course of Ilaprazole and Bismuth potassium citrate combined with two kinds of antibiotics in the treatment of Helicobacter pylori （Hp） related chronic gastritis.Methods According to random number table method，156 patients with Hp related chronic gastritis in our hospital from January 2013 to June 2015 were selected and randomly divided into group A （n=78） and group B （n=78）.All patients were treated with Ilaprazole 5 mg，Bismuth potassium citrate 0.6 g，Amoxicillin 1.0 g and Levofloxacin 0.2 g，2 times a day.Group A and group B was treated with the drugs for one week and two weeks respectively.The clinical effect，Hp eradication rate and adverse reactions between two groups were compared.Results The total effective rate of group A and group B was 93.6% and 94.9% respectively，there was no significant difference between two groups（P>0.05）.Hp eradication rate of group B （89.7%） was obviously higher than that of group A （75.6%），the difference was statistically significant （P<0.05）.Incidence rate of adverse reactions in group A and group B was 6.4% and 9.0% respectively，there was no significant difference between two groups （P>0.05）.Conclusion The cure rate and Hp eradication rate of two weeks therapeutic course of Ilaprazole and Bismuth potassium citrate combined with two kinds of antibiotics in the treatment of Hp related chronic gastritis were obviously better than one week therapeutic course，and their adverse reactions is similar.

[Key words]Helicobacter pylori；Eradication therapy；Combined therapy；Chronic gastritis

自澳大利亞学者warren和marshall成功分离出幽门螺杆菌（Helicobacter pylori，Hp）以来，大量研究证实Hp与慢性胃炎、消化性溃疡、低级别胃黏膜相关淋巴组织淋巴瘤及胃癌的发病密切相关，根除Hp治疗有促进胃黏膜炎症消退、溃疡愈合、淋巴瘤好转及预防胃癌等作用[1]。因此，Hp相关性慢性胃炎等上述疾病被列为根除Hp治疗的指征[2]。但近年来临床上抗Hp治疗过程中Hp耐药菌株不断增多，导致Hp根除率下降，严重影响治疗效果[3-5]。因此，积极探索新的、高效、耐药率低且价格适宜的根除Hp治疗方案是临床急需解决的问题。本研究应用艾普拉唑、枸橼酸铋钾联合两种抗生素治疗Hp相关性慢性胃炎，并进行1周及2周疗程的临床效果对比，现报道如下。

1资料与方……