| 游 坤.两种三联疗法治疗幽门螺杆菌感染性胃溃疡合并复发性口腔溃疡疗效对比[J].中国烧伤创疡杂志,2020,(1):59~62. |
| DOI： |
| 中文关键词: 胃溃疡 口腔溃疡 幽门螺杆菌 克拉霉素 甲硝唑 免疫功能 |
| 英文关键词:Gastric ulcer Oral ulcer H. pylori Clarithromycin Metronidazole Immune function |
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| 中文摘要: |
| 【摘要】目的 对比观察克拉霉素三联疗法与甲硝唑三联疗法治疗幽门螺杆菌（Helicobacter pylori，Hp）感染性胃溃疡合并复发性口腔溃疡的临床疗效。方法 选取2015年1月至2019年1月信阳市中医院收治的56例Hp感染性胃溃疡合并复发性口腔溃疡患者作为研究对象，并按照随机数表法将其随机分为试验组（28例）和对照组（28例），其中试验组患者采用克拉霉素、奥美拉唑、阿莫西林三联疗法予以治疗，对照组患者采用甲硝唑、奥美拉唑、阿莫西林三联疗法予以治疗，对比观察两组患者的Hp清除情况、胃溃疡与口腔溃疡愈合情况以及免疫功能变化情况。结果 试验组患者Hp清除率及胃溃疡愈合率显著高于对照组（χ2=4.978、14.275，P=0.026、0.000）、胃溃疡复发率显著低于对照组（χ2=12.600，P=0.000）、口腔溃疡治疗有效率显著高于对照组（Mann-Whitney U=216.500，Z=-3.104，P=0.002）；治疗4周后，两组患者CD3+、CD4+、CD4+/CD8+水平均显著高于治疗前（CD3+：t=19.170、8.853，P=0.000、0.000；CD4+：t=12.892、4.430，P=0.000、0.000；CD4+/CD8+：t’=20.192、9.040，P=0.000、0.000），CD8+水平显著低于治疗前（t’=14.224、5.403，P=0.000、0.000），且治疗后试验组患者CD3+、CD4+、CD4+/CD8+水平显著高于对照组（t=9.397、7.789、9.551，P=0.000、0.000、0.000），CD8+水平显著低于对照组（t=12.237，P=0.000）。结论 克拉霉素三联疗法可明显增强Hp感染性胃溃疡合并复发性口腔溃疡患者的免疫功能，提高Hp清除率及胃溃疡与口腔溃疡愈合率，降低胃溃疡复发率，效果显著优于甲硝唑三联疗法，值得临床推广应用。 |
| 英文摘要: |
| 【Abstract】Objective To compare the clinical efficacy of clarithromycin triple therapy and metronidazole triple therapy in the treatment of H. pylori infected gastric ulcer combined with recurrent oral ulcer. Methods Fifty-six patients with H. pylori infected gastric ulcer and recurrent oral ulcer, admitted to Hospital of Xinyang from January 2015 to January 2019 were selected as subjects and divided, according to random number table, into an experiment group (28 cases) and a control group (28 cases). Patients in the experiment group were treated with triple therapy consisting of clarithromycin, omeprazole and amoxicillin, and patients in the control group with triple therapy consisting of metronidazole, omeprazole and amoxicillin. Hp clearance, healing of gastric and oral ulcers, and immune function change in the two groups were compared and analyzed. Results Hp clearance rate and gastric ulcer healing rate in the experiment group were significantly higher than those in the control group (χ2 = 4.978, 14.275, P = 0.026, 0.000), the recurrence rate of gastric ulcer in the experiment group was significantly lower than that in the control group (χ2 = 12.600, P = 0.000) and the effective rate of oral ulcer treatment in the experiment group was significantly higher than that in the control group (Mann-Whitney U = 216.500, Z = -3.104, P = 0.002); After 4 weeks of treatment, levels of CD3+, CD4+, CD4+ / CD8+ in the two groups were significantly higher than that before treatment (CD3+: t = 19.170, 8.853, P = 0.000, 0.000; CD4+: t = 12.892, 4.430, P = 0.000, 0.000; CD4+ / CD8+: t '= 20.192, 9.040, P = 0.000, 0.000), level of CD8+ in the two groups was significantly lower than that before treatment (t' = 14.224, 5.403, P = 0.000, 0.000). After treatment, levels of CD3+, CD4+, CD4+ / CD8+ in the experiment group were significantly higher than those in the control group (t = 9.397, 7.789, 9.551, P = 0.000, 0.000, 0.000), and level of CD8+ was significantly lower than that in the control group (t = 12.237, P = 0.000). Conclusion Clarithromycin triple therapy can significantly enhance the immune function of patients with Hp infected gastric ulcer combined with recurrent oral ulcer, improve Hp clearance rate and the healing rate of gastric ulcer and oral ulcer, and reduce the recurrence rate of gastric ulcer. As its efficacy is much better than metronidazole triple therapy, it deserves to be promoted in clinical practice. |
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