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目的:比较吉法酯联合短期使用埃索美拉唑与分别长期单独使用吉法酯、埃索美拉唑预防小剂量阿司匹林相关性溃疡复发的疗效和安全性。方法:123例服用小剂量阿司匹林致消化性溃疡出血的患者,经6~8周治疗溃疡愈合后,按入院先后顺序分为A组(吉法酯片100 mg,po tid,长期服用)、B组(埃索美拉唑片20 mg,po qd,长期服用)、C组(吉法酯100 mg,po tid,长期服用+埃索美拉唑片20 mg,po qd,前8周服用),比较3组患者治疗0~8周、9~50周再出血发生率和不良反应发生率。结果:治疗8周后,3组患者再出血发生率比较,C组明显低于A、B两组,差异有统计学意义(P<0.05);治疗50周后,3组患者首次再出血发生率比较,差异无统计学意义(P>0.05)。治疗8周后,3组患者不良反应的发生率比较,差异无统计学意义(P>0.05);治疗50周后,3组患者不良反应比较,A、C两组患者不良反应发生率明显低于B组,差异有统计意义(P<0.05)。结论:患者短期应用埃索美拉唑联合吉法酯治疗后,再予以吉法酯维持治疗的方法,对预防及治疗小剂量阿司匹林所致溃疡及出血,能够达到与长期应用质子泵抑制药(PPI)相同的治疗效果,还可避免长期应用PPI所引起的临床并发症。
OBJECTIVE: To compare the efficacy and safety of gemcitabine combined with short-term esomeprazole and long-term use of gefitin and esomeprazole respectively to prevent relapse of low-dose aspirin-associated ulcer. Methods: 123 patients with peptic ulcer bleeding caused by low-dose aspirin were divided into group A (gefitfloxacin 100 mg, po tid, long-term use), B Group (long-term use of esomeprazole tablets 20 mg, po qd, long-term use), C group (gefitinib 100 mg, po tid, long-term use of esomeprazole tablets 20 mg, po qd, The incidences of rebleeding and adverse reactions in 0 to 8 weeks and 9 to 50 weeks in the three groups were compared. Results: After 8 weeks of treatment, the incidences of rebleeding in 3 groups were significantly lower than those in groups A and B (P <0.05). After 50 weeks of treatment, the initial rebleeding occurred in 3 groups There was no significant difference in rates (P> 0.05). There was no significant difference in adverse reactions between the three groups after 8 weeks of treatment (P> 0.05). After 50 weeks of treatment, adverse reactions in the three groups were significantly lower than those in the A and C groups In group B, the difference was statistically significant (P <0.05). Conclusion: Short-term esomeprazole combined with gefitinib treatment, and then to maintain the treatment of gefitinamide method for the prevention and treatment of low-dose aspirin-induced ulcer and bleeding, to achieve long-term use of proton pump inhibitors ( PPI) the same treatment, but also to avoid long-term clinical complications caused by PPI.