【摘要】 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5 mg，3次/d，4周，及根除幽门螺杆菌治疗（埃索美拉唑 20 mg+克拉霉素 500 mg+阿莫西林1.0 g，12次/d）2周。B组采用莫沙比利5 mg，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（Plt;0.01），与停药4周后相比差异无统计学意义（Pgt;0.05），二者均明显低于B组同期（Plt;0.05、lt;0.01）。B组症状积分治疗4周后明显下降（Plt;0.01），停药4周后明显高于治疗4周后（Plt;0.05），但仍低于治疗前（Plt;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%（Plt;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。【Abstract】 Objective To explore the therapeutic effect of helicobacter pylori (H.pylori) eradication on diabetic gastroparesis (DGP) patients. Methods A total of 100 DGP patients with H.pylori infection diagnosed between March 2008 and January 2010 were included and randomly divided into two groups. The patients in group A underwent the treatment with mosapride 5 mg (thrice per day) for four weeks and H.pylori eradication therapy (esomeprazole 20 mg, twice per day; clarithromycin 500 mg, twice per day; amoxicillin 1.0 g, twice per day for two weeks). The patients in group B was administered with mosapride 5 mg (thrice per day) for four weeks. The symptom scores (SS) were recorded pretreatment, 4 weeks later and 4 weeks after stopping treatment. Results Ninety-two patients finished the study. The SS in group A decreased significantly (Plt;0.01) 4 weeks after the treatment and didn’t differ much from that 4 weeks after stopping the treatment. Both of the SS were lower than those in group B at the same time. In group B, compared with that before the treatment, the SS were much lower than that 4 weeks after the treatment (Plt;0.01) and 4 weeks after stopping the treatment (Plt;0.05); the former was significantly lower than the latter (Plt;0.05). The marked efficacy rate and total efficacy rate in group A were higher than those in group B (4-week treatment: 57.4% and 91.5% vs. 35.6% and 75.6%, 4 weeks after stopping the treatment: 40.4% and 83% vs. 15.6% and 53.3%) (Plt;0.05). Conclusion H.pylori eradication can increase the therapeutic effect on H.pylori positive patients with DGP and reduce the recurrence of the symptoms remarkably.
目的:观察两种常用一线根除幽门螺杆菌(H.pylori)三联方案在本地区(成都市)的疗效。方法:纳入70例诊断为消化性溃疡、慢性糜烂性胃炎、慢性萎缩性胃炎伴H.pylori感染的患者。随机分为A、B两组。A组采用埃索美拉唑(E)20 mg bid+克拉霉素(C)500 mg bid+甲硝唑(M)400 mg bid,B组采用E 20 mg bid+ C 500 mg bid+阿莫西林(A)1.0g bid治疗,疗程7天。H.pylori根除失败者以1周四联方案:E 20 mg bid+胶体次枸櫞酸铋(B)220 mg bid+呋喃唑酮100 mg bid+ A1.0g bid治疗,观察疗效。结果:64例完成实验。三联方案H.pylori根除率:A组62.5%,B组84.4%,有显著差异(Plt;0.05)。二线四联方案根除率94.1%。结论:ECA方案H.pylori根除率明显高于ECM方案,可能更适合于本地区根除H.pylori的一线治疗,EBFA方案作为二线治疗具有较高疗效。