胃潰瘍合并幽門螺桿菌感染采用泮托拉唑治療的臨床觀察

于峰+孟瑩

【摘要】 目的 分析胃潰瘍合并幽門螺桿菌（Hp）感染采用泮托拉唑治療的臨床效果。方法 106例合并Hp感染的胃潰瘍患者作為研究對象， 根據治療方法不同分為觀察組（55例）與對照組（51例）。對照組患者采用阿莫西林及克拉霉素聯合法莫替丁治療， 觀察組患者采用阿莫西林及克拉霉素聯合泮托拉唑治療。比較兩組胃鏡下潰瘍愈合效果、治療前后潰瘍周圍組織成熟度、Hp根除率、潰瘍復發率、不良反應發生率。結果 觀察組胃鏡下潰瘍愈合總有效率為96.36%， 明顯高于對照組的84.31%， 差異具有統計學意義（P<0.05）。治療前， 兩組患者潰瘍周圍組織成熟度比較差異無統計學意義（P>0.05）;治療后， 觀察組患者潰瘍周圍組織成熟度明顯優于對照組， 差異具有統計學意義（P<0.05）。觀察組Hp根除率、不良反應發生率分別為83.64%、12.73%， 與對照組的78.43%、11.76%比較差異無統計學意義（P>0.05）;觀察組潰瘍復發率為5.45%， 明顯低于對照組的19.61%， 差異具有統計學意義（P<0.05）。結論 泮托拉唑治療胃潰瘍合并Hp感染的效果顯著， 可有效提高胃潰瘍愈合質量， 抑制病情復發， 且安全性尚可， 值得臨床推廣采用。

【關鍵詞】 胃潰瘍;幽門螺桿菌;泮托拉唑;法莫替丁

DOI：10.14163/j.cnki.11-5547/r.2018.03.003

【Abstract】 Objective To analyze the clinical effect of pantoprazole in the treatment of gastric ulcer complicated with Helicobacter pylori （Hp） infection. Methods A total of 106 gastric ulcer patients with Hp infection as study subjects were divided by different treatment methods into observation group （55 cases） and control group （51 cases）. The control group received amoxicillin and clarithromycin in combination with famotidine for treatment， and the observation group received amoxicillin and clarithromycin in combination with pantoprazole for treatment. Comparison were made on healing effect of ulcers under gastroscope， tissue maturity around ulceration before and after treatment， Hp eradication rate， ulcer recurrence rate and incidence of adverse reactions between two groups. Results The observation group had obviously higher total effective rate of ulcers healing under gastroscope as 96.36% than 84.31% in the control group， and the difference was statistically significant （P<0.05）. Before treatment， both groups had no statistically significant difference in tissue maturity around ulceration （P>0.05）. After treatment， the observation group had obviously better tissue maturity around ulceration than the control group， and the difference was statistically significant （P<0.05）. The observation group had Hp eradication rate and incidence of adverse reactions respectively as 83.64% and 12.73%， and there was no statistically significant difference comparing with 78.43% and 11.76% in the control group （P>0.05）. The observation group had obviously lower ulcer recurrence rate as 5.45% than 19.61% in the control group， and the difference was statistically significant （P<0.05）. Conclusion Pantoprazole shows remarkable effect in treating gastric ulcer complicated with Hp infection， and can effectively improve the healing quality of gastric ulcer， inhibit the recurrence of the disease. It is safe and worthy of clinical promotion and application.endprint

【Key words】 Gastric ulcer; Helicobacter pylori infection; Pantoprazole; Famotidine

胃潰瘍是一種發生在胃賁門至幽門間的潰瘍， 與Hp感染密切相關， 且臨床普遍認為胃潰瘍的近期愈合效果較為顯著[1]。但胃潰瘍患者停藥后的病情復發率較高， 相關的機制尚未明確， 可能與Hp持續感染、胃酸分泌紊亂、潰瘍愈合質量較差有關。針對胃潰瘍的治療， 后續抑酸治療對于提高潰瘍愈合質量、減少病情復發起到關鍵作用， 但在選擇抑制藥物上， 應注重考慮安全性這一問題。泮托拉唑可顯著抑制胃酸分泌， 有助于潰瘍愈合、恢復潰瘍周圍組織學結構和功能， 進而提高潰瘍愈合質量、抑制病情復發;同時， 泮托拉唑的安全性已得到廣泛認可[2， 3]。關于泮托拉唑能否作為胃潰瘍的首選治療藥物仍存在爭議， 長期治療的安全性尚未形成統一定論。……