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目的评价阿拉坦五味丸联合质子泵抑制剂(PPI)为主的三联疗法对幽门螺杆菌(Hp)阳性的老年慢性萎缩性胃炎患者的临床疗效与安全性。方法 2011年6月至2013年6月80例Hp阳性的老年慢性萎缩性胃炎患者随机分为两组,治疗组40例接受埃索美拉唑+阿莫西林+克拉霉素+阿拉坦五味丸治疗;对照组40例给予埃索美拉唑+阿莫西林+克拉霉素+铋剂四联治疗。观察两组Hp根除率、治疗前后胃肠道症状缓解情况及不良反应。结果治疗组与对照组Hp根除率分别为82.5%、85.0%,两组比较差异无统计学意义(P>0.05)。治疗组治疗后上腹痛、纳差、上腹胀、反酸、嗳气的症状积分均较治疗前明显减低(P均<0.05);对照组仅上腹痛、嗳气的症状积分明显减低(P均<0.05);与对照组治疗后比较,治疗组治疗后纳差、上腹胀、反酸的症状积分减低更明显(P均<0.05)。治疗组与对照组不良反应发生率分别为7.5%、27.5%,两组比较差异有统计学意义(P<0.05)。结论阿拉坦五味丸联合PPI为主的三联疗法治疗Hp阳性的老年萎缩性胃炎患者效果好、不良反应少、依从性高。
Objective To evaluate the clinical efficacy and safety of triple therapy with Alathan-Weiwei Pill combined with proton pump inhibitor (PPI) in elderly patients with Helicobacter pylori (Hp) -positive chronic atrophic gastritis. Methods From June 2011 to June 2013, 80 Hp-positive elderly patients with chronic atrophic gastritis were randomly divided into two groups. The treatment group received esomeprazole + amoxicillin + clarithromycin + Treatment; control group of 40 patients given esomeprazole + amoxicillin + clarithromycin + bismuth quadruple therapy. Hp eradication rate was observed in both groups, before and after treatment of gastrointestinal symptoms and adverse reactions. Results The eradication rates of Hp in the treatment group and control group were 82.5% and 85.0%, respectively. There was no significant difference between the two groups (P> 0.05). After treatment, the symptoms of upper abdominal pain, anorexia, upper abdominal distension, acid reflux and belching were all significantly lower than those before treatment (all P <0.05); in the control group, the symptom scores of upper abdominal pain and belching were significantly decreased (all P <0.05 ); Compared with the control group after treatment, the treatment group after treatment of anorexia, abdominal distension, acid reflux symptom scores decreased more significantly (P all <0.05). Adverse reactions in the treatment group and control group were 7.5% and 27.5%, respectively, with significant difference between the two groups (P <0.05). Conclusions The combination therapy of Alajintuweiwei pill and PPI is effective in treating Hp-positive elderly patients with atrophic gastritis with less adverse reactions and high compliance.