摘要
目的探讨联合瑞巴派特治疗在幽门螺杆菌(Hp)相关性十二指肠溃疡患者中的应用效果。方法选取2020-07-01-2021-07-19南阳市中心医院Hp相关性十二指肠溃疡患者101例,根据随机数字表法分为观察组(n=51)、对照组(n=50)。2组均给予常规四联疗法,对照组联合双歧杆菌四联活菌片治疗,0.5 g/次,2次/d,观察组在以上基础上,联合瑞巴派特治疗,0.1 g/次,3次/d。干预1个月后,通过门诊复查统计相关资料。对比2组疗效、Hp根除率、不良反应发生率、治疗前后胃部分泌物[胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、胃动素(MTL)、胃蛋白酶原Ⅱ(PGⅡ)]、病情相关因子[白细胞介素-6(IL-6)、表皮细胞生长因子(EGF)、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)水平、肿瘤坏死因子-α(TNF-α)]、免疫蛋白[免疫球蛋白A(IgA)、G(IgG)]水平及不良反应发生率。对照组失访1例,观察组失访2例,2组均49例患者完成干预。结果观察组总有效率为87.76%(43/49),高于对照组的69.39%(34/49),差异有统计学意义,χ^(2)=4.909,P=0.027;Hp根除率为89.80%(44/49),高于对照组的65.31%(32/49),差异有统计学意义,χ^(2)=8.440,P=0.004。治疗后观察组GAS水平为(126.37±13.96)ng/L,低于对照组的(147.53±16.58)ng/L,差异有统计学意义,F=26.482,P<0.001;PGⅠ水平为(226.51±23.13)μg/L,低于对照组的(252.34±28.67)μg/L,差异有统计学意义,F=9.466,P<0.001;PGⅡ水平为(13.96±1.31)μg/L,低于对照组的(16.53±1.25)μg/L,差异有统计学意义,F=12.52,P<0.001;IL-6水平为(27.68±4.26)ng/L,低于对照组的(34.95±6.21)ng/L,差异有统计学意义,F=6.758,P<0.001;TNF-α水平为(25.94±10.23)pg/L,低于对照组的(36.18±11.97)pg/L,差异有统计学意义,F=14.552,P<0.001;MMP-9水平为(79.69±13.56)g/L,低于对照组的(105.21±13.54)g/L,差异有统计学意义,F=9.322,P<0.001。治疗后观察组MTL水平为(421.34±41.05)ng/L,高于对照组的(345.56±40.67)ng/L,差异有统计学意义,F=15.387,P<0.001;EGF水平为(219.53±21.02)μg/L,高于对照组的(208.45±16.64)μg/L,差异有统计学意义,F=8.893,P<0.001;VEGF水平为(120.51±11.32)μg/L,高于对照组的(114.23±11.57)μg/L,差异有统计学意义,F=9.716,P<0.001;IgA水平为(260.13±47.45)mg/dL,高于对照组的(230.45±43.17)mg/dL,差异有统计学意义,F=12.229,P<0.001;IgG水平为(1513.42±265.42)mg/dL,高于对照组的(1303.65±242.76)mg/dL,差异有统计学意义,F=11.336,P<0.001。观察组不良反应发生率为4.08%(2/49)与对照组的6.12%(3/49)比较,差异无统计学意义,χ^(2)=0.000,P=1.000。结论联合瑞巴派特治疗Hp相关性十二指肠溃疡患者效果显著,能有效提高Hp根除率,减轻胃肠黏膜炎性反应,促进胃肠菌群平衡,调节机体免疫,且不良反应少。
Objective This study investigated the effect of combined rebamipide treatment in patients with Helicobacter pylori(Hp)-related duodenal ulcer.Methods A total of 101 patients with Hp-related duodenal ulcer in Nanyang Central Hospital from 2020-07-01 to 2021-07-19 were selected and divided into observation group(n=51)and control group(n=50)according to the random number table method.Both groups were given conventional quadruple therapy,the control group was treated with bifidobacteria quadruple viable tablet,0.5 g/time,2 times/d,and the observation group was treated with rebamipide on the basis of the above,0.1 g/time,3 times/d.After 1 month of intervention,the relevant data were re-examined through the outpatient clinic.The efficacy,Hp eradication rate,adverse reaction rate,gastric secretions before and after treatment,including gastrin(GAS),pepsinogen I(PGⅠ),motilin(MTL),pepsinogenⅡ(PGⅡ)were compared between the two groups.Disease-related factors,such as interleukin-6(IL-6),epidermal growth factor(EGF),vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9)levels,tumor necrosis factor-α(TNF-α),immunoglobulin A(IgA)and G(IgG)levels and adverse reaction rates were also compared between the two groups.Only1case in the control group was lost to follow-up,2cases in the observation group were lost to follow-up,and 49patients in both groups completed the intervention.Results The total effective rate in the observation group was 87.76%(43/49)higher than 69.39%in the control group(34/49),the difference was statistically significant,χ^(2)=4.909,P=0.027;Hperadication rate was 89.80%(44/49),higher than 65.31%(32/49)of the control group,the difference was statistically significant,χ^(2)=8.440,P=0.004.After treatment,the GAS level of the observation group was(126.37±13.96)ng/L,which was lower than that of the control group(147.53±16.58)ng/L,and the difference was statistically significant,F=26.482,P<0.001;PGⅠlevel was(226.51±23.13)μg/L,lower than that of the control group(252.34±28.67)μg/L,the difference was statistically significant,F=9.466,P<0.001;PGⅡlevel was(13.96±1.31)μg/L,lower than that of the control group(16.53±1.25)μg/L,the difference was statistically significant,F=12.529,P<0.001;IL-6level was(27.68±4.26)ng/L,lower than that of the control group(34.95±6.21)ng/L,the difference was statistically significant,F=6.758,P<0.001;the level of TNF-αwas(25.94±10.23)pg/L,lower than that of the control group(36.18±11.97)pg/L,the difference was statistically significant,F=14.552,P<0.001;MMP-9level was(79.69±13.56)g/L,which was lower than(105.21±13.54)g/L in the control group,and the difference was statistically significant,F=9.322,P<0.001.After treatment,the MTL level of the observation group was(421.34±41.05)ng/L,which was higher than that of the control group(345.56±40.67)ng/L,and the difference was statistically significant,F=15.387,P<0.001;EGF level was(219.53±21.02)μg/L,higher than that of the control group(208.45±16.64)μg/L,the difference was statistically significant,F=8.893,P<0.001;VEGF level was(120.51±11.32)μg/L,higher than that of the control group(114.23±11.57)μg/L,the difference was statistically significant,F=9.716,P<0.001;IgA level was(260.13±47.45)mg/dl,which was higher than that of the control group(230.45±43.17)mg/dl,the difference was statistically significant,F=12.229,P<0.001;the IgG level was(1513.42±265.42)mg/dl,which was higher than that of the control group(1303.65±242.76)mg/dl,the difference was statistically significant,F=11.336,P<0.001.The adverse reaction rate in the observation group was 4.08%(2/49)compared with 6.12%(3/49)in the control group,and the difference was not statistically significant,χ^(2)=0.000,P=1.000.Conclusions Combined with rebamipide in the treatment of H.pylori-related duodenal ulcer patients has significant effect,which can effectively improve the H.pylori eradication rate,reduce the inflammatory reaction of gastrointestinal mucosa,promote the balance of gastrointestinal flora,regulate the body’s immunity,and has fewer adverse reactions.
作者
赵锐豪
樊宏伟
孙晓
ZHAO Rui-hao;FAN Hong-wei;SUN Xiao(First Ward of Department of Gastroenterology,Nanyang Central Hospital,Nanyang 473000,China)
出处
《社区医学杂志》
CAS
2022年第9期505-509,共5页
Journal Of Community Medicine
关键词
瑞巴派特
双歧杆菌
幽门螺杆菌
免疫功能
根除率
rebamipide
bifidobacteria
helicobacter pylori
immune function
eradication rate
