【摘要】 目的 觀察根除幽門螺桿菌對糖尿病胃輕癱（DGP）的治療作用。 方法 選擇2008年3月-2010年1月100例幽門螺桿菌陽性DGP患者。隨機分為A、B兩組。A組給予莫沙比利5 mg，3次/d，4周，及根除幽門螺桿菌治療（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組采用莫沙比利5 mg，3次/d，4周。記錄患者治療前、治療4周及停藥4周時的癥狀積分。 結果 92例完成實驗。A組癥狀積分治療4周后明顯下降（Plt;0.01），與停藥4周后相比差異無統計學意義（Pgt;0.05），二者均明顯低于B組同期（Plt;0.05、lt;0.01）。B組癥狀積分治療4周后明顯下降（Plt;0.01），停藥4周后明顯高于治療4周后（Plt;0.05），但仍低于治療前（Plt;0.05）。A組治療4周及停藥4周后顯效率及總有效率分別為57.4%及91.5%、40.4%及83%，明顯高于B組35.6%及75.6%、15.6%及53.3%（Plt;0.05）。 結論 對幽門螺桿菌陽性的DGP患者根除幽門螺桿菌可明顯提高療效，并有效防止停藥后癥狀復發。【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:觀察兩種常用一線根除幽門螺桿菌(H.pylori)三聯方案在本地區(成都市)的療效。方法:納入70例診斷為消化性潰瘍、慢性糜爛性胃炎、慢性萎縮性胃炎伴H.pylori感染的患者。隨機分為A、B兩組。A組采用埃索美拉唑(E)20 mg bid+克拉霉素(C)500 mg bid+甲硝唑(M)400 mg bid,B組采用E 20 mg bid+ C 500 mg bid+阿莫西林(A)1.0g bid治療,療程7天。H.pylori根除失敗者以1周四聯方案:E 20 mg bid+膠體次枸櫞酸鉍(B)220 mg bid+呋喃唑酮100 mg bid+ A1.0g bid治療,觀察療效。結果:64例完成實驗。三聯方案H.pylori根除率:A組62.5%,B組84.4%,有顯著差異(Plt;0.05)。二線四聯方案根除率94.1%。結論:ECA方案H.pylori根除率明顯高于ECM方案,可能更適合于本地區根除H.pylori的一線治療,EBFA方案作為二線治療具有較高療效。