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目的观察四联疗法治疗2型糖尿病合并幽门螺杆菌阳性消化性溃疡的临床疗效。方法 176例Hp阳性消化性溃疡患者为对照组,122例2型糖尿病合并Hp阳性消化性溃疡患者为试验组。2组患者均予以口服雷贝拉唑10 mg qd+口服克拉霉素0.25 g bid+口服阿莫西林0.5 g bid+口服枸橼酸铋钾0.3 g qid。克拉霉素与阿莫西林只服用前10天,其余药均服用4周。比较2组患者的临床疗效和药物不良反应的发生情况,并分析2型糖尿病与根除Hp的关系。结果治疗后,试验组和对照组的总有效率分别为86.06%(105/122例)和94.32%(166/176例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的Hp根除率分别为72.13%(88/122例)和86.93%(153/176例),差异有统计学意义(P<0.05)。试验组的药物不良反应主要有恶心、腹泻和黑便;对照组的药物不良反应主要有恶心、腹泻和呕吐。试验组和对照组的药物不良反应发生率分别为9.83%(12/122例)和10.23%(18/176例),差异无统计学意义(P<0.05)。结论治疗后,对照组的临床疗效优于试验组,提示临床应该要根据2型糖尿病和Hp阳性消化性溃疡的双重特点综合制定治疗方案,以提高临床疗效。
Objective To observe the curative effect of quadruple therapy on Type 2 diabetes with Helicobacter pylori positive peptic ulcer. Methods 176 cases of Hp positive peptic ulcer patients as control group, 122 cases of type 2 diabetes with Hp-positive peptic ulcer patients as the experimental group. Both groups were given oral rabeprazole 10 mg qd + oral clarithromycin 0.25 g bid + oral amoxicillin 0.5 g bid + oral bismuth potassium citrate 0.3 g qid. Clarithromycin and amoxicillin only take the first 10 days, the remaining drugs were taken for 4 weeks. The clinical efficacy and adverse drug reactions in two groups were compared and the relationship between type 2 diabetes and eradication of Hp was analyzed. Results After treatment, the total effective rates of the experimental group and the control group were 86.06% (105/122 cases) and 94.32% (166/176 cases), respectively, with statistical significance (P <0.05). After treatment, the Hp eradication rates of the experimental group and the control group were 72.13% (88/122 cases) and 86.93% (153/176 cases) respectively, the difference was statistically significant (P <0.05). Adverse drug reactions in the experimental group were mainly nausea, diarrhea and melena; adverse drug reactions in the control group mainly nausea, diarrhea and vomiting. The adverse drug reaction rates of the experimental group and the control group were 9.83% (12/122 cases) and 10.23% (18/176 cases) respectively, with no significant difference (P <0.05). Conclusion After treatment, the clinical efficacy of the control group is better than that of the experimental group, suggesting that the clinical treatment should be based on the dual characteristics of type 2 diabetes and Hp-positive peptic ulcer to improve the clinical efficacy.