乙酰半胱氨酸联合三联疗法根除幽门螺杆菌的疗效观察

发布时间：2018-10-08 21:16

【摘要】：目的观察乙酰半胱氨酸联合三联疗法根除幽门螺旋杆菌的临床疗效。方法选取2014年6月至2014年12月就诊于福建省立医院消化科门诊的76例经电子胃镜明确诊断为慢性胃炎或消化性溃疡的Hp阳性患者,将这些患者随机分为实验组和对照组,实验组和对照组各38例,其中对照组给予埃索美拉唑肠溶片20mg+克拉霉素0.5g+奥硝唑分散片0.5g三联疗法治疗,每日两次;实验组在上述三联疗法的基础上加用乙酰半胱氨酸600mg,每日两次。两组的治疗时间均为14天。两组均于治疗结束后至少4周复查13C-尿素呼气试验,比较两组幽门螺杆菌根除率,同时记录药物的不良反应并比较两组不良反应发生率。结果1一般资料:实验组38例,其中女性患者16例,男性患者22例,平均年龄为49.3±12.0岁;慢性胃炎患者26例,消化性溃疡患者12例。对照组38例,其中女性患者20例,男性患者18例,平均年龄为46.8±11.3岁;慢性胃炎患者30例,消化性溃疡患者8例。两组均无失访病例及终止试验者。两组患者性别、年龄、疾病分布等资料比较差异无统计学意义(P0.05),具有可比性。2幽门螺杆菌根除率的比较:实验组38例,其中33例患者幽门螺杆菌被根除,H.pylori根除率为86.8%;对照组38例,其中25例患者幽门螺杆菌被根除,H.pylori根除率为65.8%,实验组H.pylori根除率高于对照组,差异有统计学意义(P=0.031)。实验组慢性胃炎患者H.pylori根除率为80.8%(21/26)、消化性溃疡患者H.pylori根除率为100%(12/12),消化性溃疡患者H.pylori根除率明显高于慢性胃炎患者,但差异无统计学意义(P=0.103)。3不良反应情况:实验组、对照组主要不良反应有恶心、口苦、腹胀,未予特殊处理,停用药物后可消失,药物不良反应发生率均为5.3%。结论乙酰半胱氨酸联合埃索美拉唑+克拉霉素+奥硝唑三联疗法能提高幽门螺杆菌的根除率,且不增加相关性的不良反应。
[Abstract]:Objective to observe the clinical efficacy of acetylcysteine combined with triple therapy in the eradication of Helicobacter pylori. Methods from June 2014 to December 2014, 76 Hp positive patients with chronic gastritis or peptic ulcer diagnosed by electronic gastroscopy were randomly divided into experimental group and control group. There were 38 cases in the experimental group and 38 cases in the control group. The control group was treated with esomeprazole enteric-coated tablet 20mg 0.5g ornidazole dispersible tablet 0.5g triple therapy twice a day. The experimental group was treated with acetylcysteine 600 mg, twice a day. The treatment time of both groups was 14 days. 13C-urea breath test was performed at least 4 weeks after treatment in both groups. The eradication rate of Helicobacter pylori was compared between the two groups. The adverse drug reactions were recorded and the incidence of adverse reactions in the two groups were compared. Results 1 General data: there were 38 patients in the experimental group, including 16 female patients and 22 male patients with an average age of 49.3 卤12.0 years, 26 patients with chronic gastritis and 12 patients with peptic ulcer. In the control group, there were 20 female patients and 18 male patients with an average age of 46.8 卤11.3 years, 30 patients with chronic gastritis and 8 patients with peptic ulcer. There were no cases of missing visit or termination of the trial in both groups. There was no significant difference in sex, age and disease distribution between the two groups (P0.05). The rate of eradication of Helicobacter pylori was comparable between the two groups. The eradication rate of H.pylori was 86.8 in 33 patients and 65.8 in 25 of the control group. The H.pylori eradication rate in the experimental group was significantly higher than that in the control group (P0.031). The eradication rate of H.pylori was 80.8% (21 / 26) in patients with chronic gastritis and 100% (12 / 12) in patients with peptic ulcer. The eradication rate of H.pylori in patients with peptic ulcer was significantly higher than that in patients with chronic gastritis. The main adverse reactions in the control group were nausea, bitter mouth, abdominal distension, no special treatment, and disappeared after stopping the drug. The incidence of adverse drug reactions was 5.3%. Conclusion combined therapy of acetylcysteine and esomeprazole clarithromycin ornidazole can improve the eradication rate of Helicobacter pylori without increasing the associated adverse reactions.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R573

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