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目的评价不同方法对幽门螺杆菌(Hp)阳性慢性非萎缩性胃炎合并糜烂的临床疗效。方法选择2010年3月至2013年3月收治的72例Hp阳性慢性非萎缩性胃炎合并糜烂患者,按照随机对照原则分为对照组和观察组,每组各36例。对照组患者采取单纯三联疗法(含质子泵抑制剂),予以口服20 mg埃索美拉唑+0.5 g克拉霉素+0.5 g替硝唑,每日2次。观察组患者在对照组治疗的基础上予以餐前温水口服3.2 g清胃止痛微丸,每日3次。两组患者疗程均为1周。全部患者在治疗结束后2周进行胃镜复查及治疗结束6周后进行14C尿素呼气检查。对两组患者治疗后症状改善情况、Hp根除率、胃镜下疗效评价及不良反应进行比较分析。结果观察组的症状缓解率显著高于对照组(88.9%vs 63.9%,P<0.05)。观察组胃镜下检查总有效率(88.9%vs 69.4%)及Hp根除率(72.2%vs 33.3%)显著高于对照组,差异均有统计学意义(P<0.05,P<0.01)。观察组1例患者在治疗过程中出现大便次数增多,1 d后自行消失。结论采用三联疗法联合清胃止痛微丸较单纯三联疗法治疗Hp阳性慢性非萎缩性胃炎合并糜烂,在缓解患者症状、提高Hp根除率方面临床疗效更佳。
Objective To evaluate the clinical effects of different methods on Helicobacter pylori (Hp) -positive chronic non-atrophic gastritis with erosion. Methods Seventy-two patients with Hp-positive chronic non-atrophic gastritis with erosion treated from March 2010 to March 2013 were randomly divided into control group and observation group, with 36 cases in each group. Patients in the control group were treated with simple triple therapy (with proton pump inhibitor) and given orally with 20 mg of esomeprazole + 0.5 g of clarithromycin + 0.5 g of tinidazole twice daily. Patients in the observation group were given 3.2 g of Qingwei Analgesic Pellets orally in warm water before meals for three times a day on the basis of the control group. Two groups of patients were treated for 1 week. All patients underwent endoscopy 2 weeks after the end of treatment and 14C urea breath examination 6 weeks after the end of treatment. Two groups of patients after treatment to improve the symptoms, Hp eradication rate, efficacy evaluation under endoscopy and adverse reactions were compared. Results The remission rate of the observation group was significantly higher than that of the control group (88.9% vs 63.9%, P <0.05). The total effective rate (88.9% vs 69.4%) and Hp eradication rate (72.2% vs 33.3%) in the observation group were significantly higher than those in the control group (P <0.05, P <0.01). One patient in the observation group showed an increase in the number of stool during the course of treatment, and disappeared on the 1st after the treatment. Conclusions The triple therapy combined with Qingwei analgesic pellets is better than simple triple therapy in the treatment of Hp positive chronic non-atrophic gastritis with erosion. It has better clinical efficacy in alleviating the symptoms and improving the eradication rate of Hp.