目的 探討復(fù)方田七胃痛片聯(lián)合以埃索美拉唑鎂腸溶片為基礎(chǔ)的四聯(lián)療法治療難治性消化性潰瘍的臨床療效.方法 選擇2013 年3 月-2015 年3 月遼寧省人民醫(yī)院消化內(nèi)科收治的消化性潰瘍患者149 例,隨機分為對照組(75 例)和治療組(74 例).對照組口服埃索美拉唑鎂腸溶片20 mg/次,2 次/d;果膠鉍膠囊3 粒/次,3 次/d;克拉霉素片0.5 g/次,2 次/d;阿莫西林膠囊1 g/次,2 次/d.治療組在對照組的基礎(chǔ)上口服復(fù)方田七胃痛片4 片/次,3 次/d.8 周后評價療效.比較臨床療效、鏡下療效、幽門螺桿菌的消除情況以及胃竇黏膜一氧化氮(NO)和內(nèi)皮素(ET)水平.結(jié)果 治療組臨床療效的有效率、顯效率分別為97.30%、86.49%,對照組的有效率、顯效率分別為85.33%、66.67%,兩組比較的差異具有統(tǒng)計學(xué)意義(P< 0.05).治療組的鏡下療效有效率為98.65%,高于對照組(90.67%),兩組比較差異具有統(tǒng)計學(xué)意義(P< 0.05).治療組的根除率(91.89%)高于對照組(76.00%),兩組比較差異具有統(tǒng)計學(xué)意義(P< 0.05).治療后兩組NO 水平升高,ET 水平下降,與治療前比較差異均具有統(tǒng)計學(xué)意義(P< 0.01);與對照組比較,治療組NO 水平上升,ET 水平下降,兩組差異具有統(tǒng)計學(xué)意義(P< 0.01).結(jié)論 復(fù)方田七胃痛片聯(lián)合以埃索美拉唑鎂腸溶片為基礎(chǔ)的四聯(lián)療法具有較好的臨床療效,加快潰瘍愈合,消除幽門螺桿菌,其機制可能與提高胃竇黏膜NO 水平、降低ET 水平有關(guān).

Objective To investigate the clinical curative effect of Compound Tianqi Weitong Tablets combined with quadruple therapy based on Esomeprazole Magnesium Enteric-coated Tablets in treatment of refractory peptic ulcer. Methods Patients (149 cases) with refractory peptic ulcer from Department of Gastroenterology in The People's Hospital of Liaoning Province from March 2013 to March 2014 were randomly divided into control and treatment groups, with 75 and 74 cases, respectively. The patients in the control group were given quadruple therapy based on po administration with Esomeprazole Magnesium Enteric-coated Tablets, 20 mg/time, twice daily; Bismuth Pectin Capsules, 3 capsules/time, three times daily; Clarithromycin Tablets 0.5 g/time, twice daily; Amoxicillin Capsules 1 g/time, twice daily. The patients in the treatment group were po administered with Tianqi Weitong Tablets on the basis of the control group, 4 tablets /time, three times daily. Patients in both groups were treated for 8 weeks. The clinical efficacies, efficacies under microscope, and elimination of Helicobacter pylori between two groups were observed after treatment. At the same time, the levels of NO and ET in gastric antrum mucosa of two groups were compared. Results The effective rate and obvious effective rate of clinical efficacies in the treatment group were 97.30% and 86.49%, respectively, and those in the control group were 85.33% and 66.67%, with significant difference between two groups (P < 0.05). The effective rate of efficacy under microscope in the treatment group was 98.65%, above 90.67% of the control group, and there were differences between two groups (P < 0.05). The eradication rate in the treatment group (91.89%) was above that of the control group (90.67%), and the difference was statistically significant (P < 0.05). After treatment, levels of NO in two groups were significantly increased, but those of ET were significantly reduced, and the difference was statistically significant in the same group (P < 0.01). Compared with the control group,levels of NO in the treatment group increased, but those of ET decreased, and there was significant difference between two groups (P < 0.01). Conclusion Compound Tianqi Weitong Tablets combined with quadruple therapy based on Esomeprazole Magnesium Enteric-coated Tablets has the good clinical effect in treatment of refractory peptic ulcer, can accelerate refractory peptic ulcer healing, eliminate H. pylori, and its mechanism may related to improvement of NO levels and reduction of ET levels in gastric antrum mucosa.