知识与财富的链接
目的 观察二联法及含铋四联法治疗合并幽门螺旋杆菌（Hp）感染慢性萎缩性胃炎的临床效果。方法 该研究为前瞻性研究,选择黄河科技学院附属医院2022年8月至2023年8月期间收治的136例合并Hp感染的萎缩性胃炎患者为研究对象,以计算机随机分组法将其均分为两组,68例为四联组,采用含铋四联法治疗,其余68例为二联组,采用阿莫西林胶囊+富马酸伏诺拉生治疗,比较两组患者的服药依从性、治疗效果及治疗安全性。结果 在不同治疗方案下,二联组的服药依从性优良率[88.24%(60/68)]高于四联组[66.18%(45/68)];二联组的钙粘附蛋白E (E-cadherin)表达评分、中性粒细胞数（NE）、白细胞计数（WBC）分别为（2.42±0.27）分、（4.22±1.36）×10～9/L、（7.49±1.47）×10～9/L,均低于四联组[（3.35±0.82）分、（5.31±1.85）×10～9/L、（8.24±1.72）×10～9/L];二联组的Hp根除率[85.29%(58/68)]高于四联组[72.06%(49/68)];二联组的胃蛋白酶Ⅰ（PGⅠ）、胃蛋白酶Ⅱ（PGⅡ）分别为（150.25±20.74）ng/mL、（85.25±10.37）ng/mL,均高于四联组[（135.61±20.33） ng/m L、（80.46±10.29） ng/m L];二联组的药物相关副反应发生率[5.88%(4/68)]低于四联组[19.12%(13/68)],差异均有统计学意义（P<0.05）。结论 与常规含铋四联法相比,阿莫西林胶囊+富马酸伏诺拉生二联法可提升合并Hp感染萎缩性胃炎患者的服药依从性,对缓解炎症反应、促进胃消化功能恢复并降低药物相关副反应发生风险均有积极意义。
Objective To observe of the clinical effects of dual therapy and bismuth containing quadruple therapy in the treatment of chronic atrophic gastritis complicated with Hp infection.Methods This study is a prospective study, selecting 136 patients with atrophic gastritis complicated with Hp infection admitted between August 2022 and August 2023 as the study subjects. They were randomly divided into two groups using computer randomization method. Among them, 68 cases were classified as the quadruple group and treated with bismuth containing quadruple therapy, while the remaining 68 cases were classified as the bipartite group and treated with amoxicillin capsules and vonoprazan fumarate. The medication adherence, therapeutic efficacy and safety of the two groups of patients were compared.Results Under different treatment regimens, the excellent and good compliance rate of medication in the bipartite group was 88.24% (60/68), higher than the quadruple group of 66.18% (45/68) (P<0.05). The E-cadherin expression score, NE, and WBC of the bipartite group were 2.42±0.27 points, (4.22±1.36)×109/L, (7.49±1.47)×109/L, lower than the quadruple group [3.35±0.82 points, (5.31±1.85)×109/L, (8.24±1.72)×109/L] (P<0.05). The Hp eradication rate was 85.29% (58/68), higher than the quadruple group [72.06% (49/68)] (P<0.05). The PGI and PGII levels in the bipartite group were 150.25±20.74 ng/mL and 85.25±10.37 ng/mL, higher than the quadruple group (135.61±20.33 ng/mL and 80.46±10.29 ng/mL) (P<0.05). The incidence of drug-related side effects in the bipartite group was 5.88% (4/68), lower than that in the quadruple group [19.12% (13/68)] (P<0.05).Conclusion Compared with the conventional bismuth containing quadruple method, the combination of amoxicillin capsules and vonoprazan fumarate can improve medication compliance in patients with atrophic gastritis complicated with Hp infection. It has a positive significance in alleviating inflammation, promoting gastric digestive function recovery, and reducing the risk of drug-related side effects.
