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目的客观评价三联疗法对消化性溃疡患者胃黏膜抗炎及抑制幽门螺杆菌Hp感染的作用。方法选择2007年1月-2009年12月于我院门诊及住院收治的Hp相关性消化性溃疡患者148例,分为实验组与对照组各74例,实验组采用埃索美拉唑、克拉霉素、阿莫西林三联疗法治疗,对照组仅给予埃索美拉唑治疗,疗程均2周。两组患者均于治疗前及疗程结束后4周进行电子胃镜检查、组织病理学及Hp检测,并随访两组患者治疗过程中的不良反应。结果三联疗法治疗患者溃疡愈合率明显高于单用埃索美拉唑治疗,且三联疗法能有效地清除和减轻溃疡灶周围粘膜炎症,其疗效明显优于单用埃索美拉唑治疗(P<0.05)。对根除Hp感染的疗效也明显优于单用埃索美拉唑治疗的对照组(P<0.05)。两组患者治疗过程中均未发现明显肝、肾功能损害,均能耐受继续治疗,且两组不良反应发生率差异无统计学意义(P>0.05)。结论埃索美拉唑、克拉霉素、阿莫西林三联治疗方案能有效地根除Hp和减轻胃粘膜炎症,有助于溃疡愈合。
Objective To objectively evaluate the anti-inflammatory effects of triple therapy on Helicobacter pylori Hp infection in patients with peptic ulcer. Methods 148 patients with Hp-related peptic ulcer admitted to our hospital from January 2007 to December 2009 were divided into experimental group and control group (74 cases each). In the experimental group, esomeprazole and carat Amoxicillin triple therapy, the control group was given only esomeprazole treatment, treatment were 2 weeks. Two groups of patients before treatment and 4 weeks after the end of the course of electronic gastroscopy, histopathology and Hp detection, and follow-up two groups of patients during treatment of adverse reactions. Results The healing rate of ulcer in triple therapy group was significantly higher than that of esomeprazole alone group, and the triple therapy could effectively remove and relieve mucosal inflammation around ulcer group, and the curative effect was better than that of esomeprazole alone group (P <0.05). Efficacy of eradication of Hp infection was also significantly better than the control group (P <0.05) only with esomeprazole alone. No significant liver and kidney damage was found during the course of treatment in both groups, and both groups were able to tolerate continuous treatment. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Esomeprazole, clarithromycin, amoxicillin triple therapy can effectively eradicate Hp and reduce gastric mucosal inflammation, help ulcer healing.