论文部分内容阅读
目的 :观察短程低剂量“新三联”对消化性溃疡的胃粘膜保护作用并探讨其可能的机制。方法 :采用前瞻性、随机双盲、安慰剂对照研究 ,40例HP阳性消化性溃疡被随机分为两组 :A组 (新三联 ) :达克普隆 30mg ,每日 1次 +阿莫西林 5 0mg ,每日 2次 +克拉霉素 2 5 0mg ,每日 2次 ,连服 10天 ;B组 (安慰剂 ) :胃舒平 3片 ,每日 2次 ,连服 2 8天。治疗前及治疗后 4周复查胃镜 ,检测胃粘膜磷脂、氨基已糖和血清表皮生长因子 (EGF)。结果 :HP根治率、溃疡愈合率在A组 ( 92 %、88% )明显高于B组 ( 0 .0 %、2 0 % ) (均P <0 .0 1)。具有较高HP根治率的A组治疗后氨基已糖含量 (mg/g48.7± 18.4)高于治疗前 (mg/g 41.7± 15 .6 ,P <0 .0 5 ) ,磷脂和EGF治疗前较治疗后有所提高 ,但无统计学意义。治疗后组间比 ,A组EGF( 0 .5 8± 0 .2 )高于B组 ( 0 .46± 0 .2 ,P <0 .0 2 5 ) ;B组磷脂、氨基已糖和EGF治疗前后无明显变化。结论 :短程低剂量“新三联”疗法具有一定的胃粘膜保护作用。可能主要与其根除HP感染有关。另外 ,阿莫西林和兰索拉唑通过增加胃粘膜血流进而改善粘膜磷脂、氨基已糖和内源性EGF的代谢 ,也可能为其粘膜保护机制之一
Objective: To observe the gastric mucosal protective effect of short-dose and low-dose “neo-triple” on peptic ulcer and to explore its possible mechanism. Methods: A prospective, randomized, double-blind, placebo-controlled study was performed. Forty HP-positive peptic ulcer patients were randomized into two groups: group A (neo-triple): daclopronide 30 mg once daily plus amoxicillin 50 mg twice daily plus clarithromycin 250 mg twice daily for 10 days. Group B (placebo): 3 tablets of stomach Shu Ping twice daily for 2 to 8 days. Gastroscopy was performed before treatment and 4 weeks after treatment, and gastric mucosal phospholipid, aminohexose and serum epidermal growth factor (EGF) were detected. Results: The radical cure rate and ulcer healing rate in group A (92%, 88%) were significantly higher than those in group B (0. 0%, 20%) (all P <0.01). A group with high HP cure rate after treatment of aminohexose content (mg / g48.7 ± 18.4) higher than before treatment (mg / g 41.7 ± 15.6, P <0.05), phospholipid and EGF treatment Before treatment than after the increase, but not statistically significant. After treatment, the EGF in group A was significantly higher than that in group B (0.48 ± 0.2 vs 0.46 ± 0.2, P <0.05); the phospholipid, aminohexose and EGF in group B No significant change before and after treatment. Conclusion: The short-range and low-dose “neo-triple therapy” has certain gastric mucosal protective effect. It may be mainly related to its eradication of HP infection. In addition, amoxicillin and lansoprazole improve mucosal phospholipid, aminohexose and endogenous EGF metabolism by increasing gastric mucosal blood flow, and may also be one of the mucosal protective mechanisms