雷貝拉唑三聯療法治療幽門螺桿菌相關十二指腸潰瘍的臨床療效

曾貴利+李濤

[摘要] 目的 探討雷貝拉唑三聯療法治療幽門螺桿菌相關十二指腸潰瘍的臨床療效。方法 方便選取2015年6—12月該院消化內科收治的幽門螺桿菌陽性的十二指腸潰瘍患者80例作為觀察對象。采用隨機數表法將所有患者分為觀察組與對照組，對照組40例患者采用常規奧美拉唑、阿莫西林、克拉霉素藥物治療，觀察組40例患者則采用阿莫西林、克拉霉素聯合雷貝拉唑治療，比較兩組患者藥物治療效果，并對比兩組患者幽門螺桿菌根除率，隨訪復發率以及不良反應發生結果。 結果 觀察組患者治療后的總有效率為95.00%、幽門螺桿菌根除率為90.00%，明顯高于對照組的77.50%、72.50%（P<0.05），但兩組患者不良反應發生率比較差異無統計學意義（P>0.05）；并且隨訪1年結果顯示觀察組患者幽門螺桿菌相關十二指腸潰瘍復發率（5.00%）明顯低于對照組復發率（25.00%），差異有統計學意義（P<0.05）。 結論 采用雷貝拉唑三聯療法治療幽門螺桿菌相關十二指腸潰瘍臨床療效顯著，并且患者幽門螺桿菌根除率較高，治療后不易復發，可作為幽門螺桿菌陽性的十二指腸潰瘍患者首選藥物治療方案。

[關鍵詞] 雷貝拉唑三聯療法；幽門螺桿菌；十二指腸潰瘍；臨床療效

[中圖分類號] R4 [文獻標識碼] A [文章編號] 1674-0742（2017）03（b）-0147-03

[Abstract] Objective To study the clinical curative effect of triple therapy of rabeprazole in treatment of helicobacter pylori associated duodenal ulcers. Methods 80 cases of patients with helicobacter pylori associated duodenal ulcers admitted and treated in the digestive system department in our hospital from June to December 2015 were convenient selected and randomly divided into two groups with 40 cases in each， the control group adopted the routine treatment of omeprazole， amoxicillin and clarithromycin， while the observation group adopted the triple therapy of omeprazole， amoxicillin and clarithromycin， and the drug treatment effect was compared between the two groups， and the eradication rate of helicobacter pylori， recurrence rate of follow-up and adverse reactions were compared between the two groups. Results The total effective rate and eradication rate of helicobacter pylori after treatment in the observation group were obviously higher than those in the control group， （95.00%， 90.00% vs 77.50%， 72.50%），（P<0.05）， but the difference in the incidence rate of adverse reactions between the two groups had no statistical significance（P>0.05）， and the 1-year follow-up results showed that the recurrence rate in the observation group was obviously lower than that in the control group（5.00% vs 25.00%）， and the difference had statistical significance（P<0.05）. Conclusion The clinical curative effect of triple therapy of rabeprazole in treatment of helicobacter pylori associated duodenal ulcers is obvious with higher eradication rate of helicobacter pylori， and it is hard to recrudesce， which can be used as the primary drug treatment plan of positive patients with helicobacter pylori associated duodenal ulcers.

[Key words] Triple therapy of rabeprazole； Helicobacter pylori； Duodenal ulcers； Clinical curative effect

十二指腸潰瘍是臨床上最為常見的消化性潰瘍之一，相關調查顯示十二指腸潰瘍發病率在所有消化性潰瘍中僅次于胃潰瘍，患者主要表現為周期性、節律性的上腹部疼痛、腹脹、惡心、反酸等，當治療不及時或病情較重時可導致潰瘍出血、穿孔等不良臨床結局的發生[1]。現有臨床研究結果證實，幽門螺桿菌感染是導致胃潰瘍、十二指腸潰瘍發生的重要原因之一，而臨床治療也以抑制胃酸分泌、抗幽門螺桿菌感染為主，目前質子泵抑制劑聯合抗生素三聯療法治療十二指腸潰瘍是較為常用的手段，但藥物應用方案相對較多，療效以及藥物應用的安全性方面也存在較大的差異[2-3]。為進一步提升幽門螺桿菌相關十二指腸潰瘍的臨床治療效果，該組研究通過對2015年6—12月該院收治80例患者進行隨機對照分析，探討雷貝拉唑三聯療法治療幽門螺桿菌相關十二指腸潰瘍的臨床療效，現報道如下。