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[目的]探讨胃复春联合三联疗法治疗幽门螺杆菌(Hp)相关性糜烂性胃炎的临床疗效。[方法]选取70例确诊为慢性糜烂性胃炎伴Hp感染的患者,随机分为观察组(35例)和对照组(35例),对照组患者给予三联疗法(兰索拉唑,30mg/次,2次/d;阿莫西林克拉维酸钾7:1分散片,914mg/次,2次/d;克拉霉素,0.5g/次,2次/d)根除Hp治疗2周,后2周单用兰索拉唑,30mg/次,2次/d)。观察组患者给予胃复春联合三联疗法(胃复春,4片/次,3次/d;兰索拉唑,30mg/次,2次/d;阿莫西林克拉维酸钾7:1分散片,914mg/次,2次/d;克拉霉素,0.5g/次,2次/d),根除Hp治疗2周,后2周单用胃复春,4片/次,3次/d。观察2组患者胃痛、胃胀、反酸等症状缓解时间,13C呼气试验检查Hp根除情况和胃镜检查复发情况、药物经济学评价指标、不良反应。[结果]观察组临床有效率(91.4%)明显高于对照组(77.1%),2组差异有统计学意义(P<0.05);观察组与对照组临床症状积分较治疗前有明显下降,但观察组患者下降幅度明显优于对照组,差异有统计学意义(P<0.01);观察组患者1周内临床症状缓解的发生率(97.1%)明显高于对照组(77.1%),2组差异有统计学意义(P<0.05);观察组Hp根除率为82.9%,对照组Hp根除率为45.7%,2组差异有统计学意义(P<0.01);随访时间6个月,随访率100%,观察组患者共有8例复发,对照组患者共有17例复发,2组复发率比较差异有统计学意义(P<0.05);每增加一个单位效果,观察组的单位成本投入为18.14元,对照组的单位成本为21元,对照组比观察组多投入2.86元;2组患者在观察期间未出现明显不良反应。[结论]胃复春联合三联疗法治疗Hp相关性糜烂性胃炎具有良好的临床疗效,可有效改善患者的临床症状和体征,具有良好远期临床疗效,是一种合理、经济、有效的治疗方案,值得临床推广。
[Objective] To investigate the clinical efficacy of Weifuchun combined with triple therapy in the treatment of Helicobacter pylori (Hp) -related erosive gastritis. [Methods] Seventy patients diagnosed as chronic erosive gastritis with Hp infection were randomly divided into observation group (35 cases) and control group (35 cases). Patients in the control group were given triple therapy (lansoprazole, 30mg / time , 2 times / d; amoxicillin potassium clavulanic acid 7: 1 disperse tablets, 914mg / time, 2 times / d; clarithromycin, 0.5g / time, 2 times / d) Weekly with lansoprazole, 30mg / time, 2 times / d). Patients in the observation group were treated with Wei Fu Chun combined with triple therapy (Weifuchun, 4 tablets / time, 3 times / d; lansoprazole, 30mg / time, 2 times / d; amoxicillin potassium clavulanate 7: 1 Tablets, 914mg / times, 2 times / d; clarithromycin, 0.5g / times, 2 times / d), eradication of Hp treatment for 2 weeks, 2 weeks after rehydration alone, 4 tablets / time, 3 times / d . The gastric pain, bloating, acid reflux and other symptoms were observed in two groups. The 13C breath test was used to examine the eradication of Hp and the recurrence of gastroscopy. The evaluation indexes of pharmacoeconomics and adverse reactions were observed. [Results] The clinical effective rate (91.4%) in the observation group was significantly higher than that in the control group (77.1%), the difference was statistically significant (P <0.05). The clinical symptom scores of the observation group and the control group were significantly lower than those before treatment, (P <0.01). The incidence of clinical symptom relief in the observation group was significantly higher than that in the control group (97.1%) in one week (77.1%), while the observation group was significantly better than the control group (P <0.01) (P <0.05). Hp eradication rate was 82.9% in the observation group and 45.7% in the control group, with significant difference between the two groups (P <0.01). The follow-up time was 6 months and followed up The rate of recurrence in the observation group was significantly higher than that in the observation group (8%). There were 17 relapse cases in the control group and the recurrence rate in the 2 groups was statistically significant (P <0.05). For each unit effect, the unit cost of the observation group was 18.14 Yuan, the unit cost of the control group was 21 yuan, and the control group invested 2.86 yuan more than the observation group. There were no obvious adverse reactions in the two groups during the observation period. [Conclusion] Weifuchun combined with triple therapy for Hp-related erosive gastritis has good clinical efficacy, which can effectively improve the clinical symptoms and signs of patients with good long-term clinical efficacy, which is a reasonable, economical and effective treatment plan , It is worth clinical promotion.