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目的观察根除幽门螺杆菌对糖尿病胃轻瘫(DGP)的治疗作用。方法选择2008年3月2010年1月100例幽门螺杆菌阳性DGP患者。随机分为A、B两组。A组给予莫沙比利5mg,3次/d,4周,及根除幽门螺杆菌治疗(埃索美拉唑20mg+克拉霉素500mg+阿莫西林1.0g,12次/d)2周。B组采用莫沙比利5mg,3次/d,4周。记录患者治疗前、治疗4周及停药4周时的症状积分。结果 92例完成实验。A组症状积分治疗4周后明显下降(P<0.01),与停药4周后相比差异无统计学意义(P>0.05),二者均明显低于B组同期(P<0.05、<0.01)。B组症状积分治疗4周后明显下降(P<0.01),停药4周后明显高于治疗4周后(P<0.05),但仍低于治疗前(P<0.05)。A组治疗4周及停药4周后显效率及总有效率分别为57.4%及91.5%、40.4%及83%,明显高于B组35.6%及75.6%、15.6%及53.3%(P<0.05)。结论对幽门螺杆菌阳性的DGP患者根除幽门螺杆菌可明显提高疗效,并有效防止停药后症状复发。
Objective To observe the therapeutic effect of Helicobacter pylori eradication on diabetic gastroparesis (DGP). Methods One hundred 100 H. pylori positive DGP patients were selected from March 2008 to January 2010. Randomly divided into A, B two groups. Group A was given mosapride 5 mg three times per day for 4 weeks and H. pylori was eradicated (esomeprazole 20 mg + clarithromycin 500 mg + amoxicillin 1.0 g for 12 weeks) for 2 weeks. B group Mosapride 5mg, 3 times / d, 4 weeks. Record patients before treatment, treatment for 4 weeks and withdrawal symptoms 4 weeks. Results 92 cases completed the experiment. The score of symptom in group A decreased significantly after 4 weeks of treatment (P <0.01), but there was no significant difference after 4 weeks of treatment (P> 0.05), both of which were significantly lower than those in group B at the same period (P <0.05, 0.01). The score of symptom in group B decreased significantly after 4 weeks of treatment (P <0.01), and after 4 weeks of treatment, it was significantly higher than that before treatment (P <0.05), but still lower than that before treatment (P <0.05). The effective rate and total effective rate of group A were 57.4% and 91.5%, 40.4% and 83% respectively after 4 weeks of treatment and 4 weeks of withdrawal, which were significantly higher than 35.6% and 75.6%, 15.6% and 53.3% respectively in group B (P <0.05) . Conclusion Helicobacter pylori-positive DGP can effectively improve the efficacy of Helicobacter pylori and effectively prevent the recurrence of symptoms after stopping drug treatment.