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目的探讨埃索美拉唑联合莫沙比利、克拉霉素、阿莫西林治疗幽门螺杆菌(Hp)相关吻合口溃疡的效果。方法将94例患者随机分为两组:治疗组48例,对照组46例。治疗组采用埃索美拉唑40 mg每日1次,早晨空腹服用,莫沙比利5 mg每日3次,克拉霉素500 mg每日2次,阿莫西林1.0 g每日2次,疗程1周;1周后继续口服埃索美拉唑40 mg每日1次,莫沙比利5 mg每日3次。对照组采用埃索美拉唑40 mg每日1次,早晨空腹服用,克拉霉素500 mg每日2次,阿莫西林1.0 g每日2次,疗程1周;1周后继续口服埃索美拉唑40 mg每日1次。治疗后3 d、7 d和4周后观察并比较两组的治疗效果。结果治疗组镜下溃疡治愈46例(96%),显效1例(2%),3 d内临床症状改善47例(98%)。对照组镜下溃疡治愈30例(65%),显效1例(2%),3 d内临床症状改善20例(43.5%)。两组比较差异有统计学意义(P<0.05)。治疗组Hp根除率98%,对照组Hp根除率93.5%,两组比较差异无统计学意义(P>0.05)。结论埃索美拉唑联合莫沙比利、阿莫西林、克拉霉素四联疗法治疗Hp相关吻合口溃疡的效果优于埃索美拉唑、阿莫西林、克拉霉素三联疗法,可有效促进吻合口溃疡愈合。
Objective To investigate the effect of esomeprazole combined with mosapride, clarithromycin and amoxicillin in the treatment of anastomotic ulcer associated with Helicobacter pylori (Hp). Methods 94 patients were randomly divided into two groups: treatment group 48 cases, control group 46 cases. The treatment group with esomeprazole 40 mg once daily, morning fasting, mosapride 5 mg three times a day, clarithromycin 500 mg twice daily, amoxicillin 1.0 g twice daily, Course of 1 week; 1 week after oral administration of esomeprazole 40 mg once a day, mosapride 5 mg 3 times a day. The control group was given esomeprazole 40 mg once daily in the morning on an empty stomach, clarithromycin 500 mg twice daily, amoxicillin 1.0 g twice daily for 1 week, Melaprazole 40 mg once daily. After 3 days, 7 days and 4 weeks after treatment, the therapeutic effect was observed and compared between the two groups. Results In the treatment group, 46 cases (96%) were cured by endoscopic ulcer, 1 case (2%) markedly improved and 47 cases (98%) improved clinical symptom within 3 days. In the control group, ulcer was cured in 30 cases (65%), markedly effective in 1 case (2%), clinical symptoms improved in 20 cases (43.5%) in 3 days. The difference between the two groups was statistically significant (P <0.05). The treatment group Hp eradication rate was 98%, control group Hp eradication rate was 93.5%, no significant difference between the two groups (P> 0.05). Conclusion Esomeprazole combined with mosapride, amoxicillin and clarithromycin quadruple therapy is superior to esomeprazole, amoxicillin and clarithromycin triple therapy in the treatment of Hp-associated anastomotic ulcer Promote anastomotic ulcer healing.