雷贝拉唑联合复方谷氨酰胺治疗幽门螺杆菌阴性胃溃疡的疗效观察

中国药物警戒 ›› 2017, Vol. 14 ›› Issue (1): 19-21.

雷贝拉唑联合复方谷氨酰胺治疗幽门螺杆菌阴性胃溃疡的疗效观察

张强

重庆市长寿区人民医院消化内科,重庆 401220

收稿日期:2017-02-16 修回日期:2017-02-16 出版日期:2017-01-20 发布日期:2017-02-16
作者简介:张强,男,本科,主治医师,消化内科。

Efficacy of Rabeprazole Combined with Compound Glutamine in Treatment of Helicobacter Pylori Negative Gastric Ulcer

ZHANG Qiang

Department of Gastroenterology, Chongqing People’s Hospital, Chongqing 401220, China

Received:2017-02-16 Revised:2017-02-16 Online:2017-01-20 Published:2017-02-16

摘要/Abstract

摘要： 目的探讨雷贝拉唑联合复方谷氨酰胺治疗幽门螺杆菌阴性胃溃疡的疗效及对血清胃泌素水平的影响。方法收集我院收治幽门螺杆菌阴性胃溃疡患者共90例,根据数字表法随机分为治疗组和对照组,两组均45例。对照组口服雷贝拉唑钠肠溶片,10 mg/次,qd;治疗组在对照组基础上给予复方谷氨酰胺肠溶胶囊,口服,0.67 g/次,tid;两组坚持用药4周。比较两组临床疗效、不良反应、复发病例数及胃黏膜厚度、炎性细胞浸润程度、腺体密度;检测两组胃泌素水平。结果治疗组总有效率为95.56%,明显高于对照组的75.56%（χ²=5.754,P<0.05）;治疗组患者的头痛等不良反应发生率为4.44%,明显低于对照组的22.22%（P<0.05）;1年期随访,治疗组复发率6.67%,明显少于对照组的24.44%（P<0.05）;治疗组治疗后黏膜厚度、炎性细胞浸润及腺体密度评分明显低于对照组（P<0.05）;治疗组治疗后2周和4周患者胃泌素水平分别明显低于对照组（P<0.05）。结论雷贝拉唑联合复方谷氨酰胺治疗幽门螺杆菌阴性胃溃疡的疗效明显,能有抑制胃泌素的分泌。

关键词: 雷贝拉唑, 复方谷氨酰胺, 幽门螺杆菌, 胃溃疡

Abstract: ObjectiveTo investigate the effect of rabeprazole combined with compound glutamine in treatment of Helicobacter pylori negative gastric ulcer and its effect on the level of serum gastrin. Methods90 patients with Helicobacter pylori negative gastric ulcer in our hospital were involved in the study and randomly divided into two groups, 45 cases in each group. Control group were given rabeprazole sodium enteric-coated tablets, 10 mg, qd; treatment group were given compound glutamine entersoluble capsules on the basis of the control group, 0.67 g each time, tid; two groups adhere to medication for 4 weeks. The clinical curative effect, adverse reaction, the number of recurrent cases, the thickness of gastric mucosa, the degree of infiltration of inflammatory cells and the gland density of the two groups were compared, and the gastrin levels in the two groups were detected. ResultsThe total efficiency of treatment group was 95.56%, which was significantly higher than that in the control group of 75.56% ( χ²=5.754, P < 0.05). The total incidence rate of adverse reactions such as headache in the treatment group was 4.44%, which was significantly lower than that in the control group of 22.22% ( P < 0.05). The result of 1 year of follow-up showed that the recurrence rate in the treatment group was 6.67%, which was significantly lower than that in the control group of 24.44% ( P < 0.05). The mucosal thickness, inflammatory cell infiltration and the gland score after treatment in the treatment group were significantly lower than those in the control group ( P < 0.05). The gastrin levels of 2 weeks and 4 weeks after treatment in the treatment groups were lower than those in the control group respectively ( P < 0.05). ConclusionThe curative effect of rabeprazole combined with compound glutamine in the treatment of Helicobacter pylori negative gastric ulcer is obvious, it can inhibit the secretion of gastrin.

Key words: rabeprazole, compound glutamine, Helicobacter pylori, gastric ulcer

中图分类号:

R975

张强. 雷贝拉唑联合复方谷氨酰胺治疗幽门螺杆菌阴性胃溃疡的疗效观察[J]. 中国药物警戒, 2017, 14(1): 19-21.

ZHANG Qiang. Efficacy of Rabeprazole Combined with Compound Glutamine in Treatment of Helicobacter Pylori Negative Gastric Ulcer[J]. Chinese Journal of Pharmacovigilance, 2017, 14(1): 19-21.

参考文献

[1] 刘林, 王垂杰, 郑洪新,等. “以效证因”消痈溃得康治疗胃溃疡胃毒热证的随机双盲对照临床试验[J]. 世界科学技术:中医药现代化, 2012, 14(2): 1399-1404.
[2] 余小杰, 吴云, 肖丽娜. 氟哌噻吨美利曲辛治疗胃溃疡并发抑郁症36例[J]. 医药导报, 2012, 31(10): 1310-1311.
[3] 陈鹏, 唐进先, 吴冬寒. 胃溃疡患者应用质子泵抑制剂的远期风险研究[J], 中国中西医结合消化杂志, 2015, 23(9): 615-617.
[4] 刘兆远, 胡靖雪. 铝碳酸镁联合奥美拉唑治疗胃溃疡48例临床观察[J], 中国实用内科杂志, 2015, 35(1): 156-157.
[5] 侯庆柱, 雷贝拉唑和克拉霉素联合阿莫西林疗法治疗胃溃疡的疗效观察[J], 现代预防医学, 2014, 41(5): 78-79.
[6] 唐干益, 蒋忠新. 复方谷氨酰胺、泮托拉唑联合应用治疗胃溃疡及胃炎的疗效分析[J]. 海峡药学, 2004, 16(6): 98-99.
[7] 中华消化杂志编委会. 消化性溃疡病诊断与治疗规范(2013年,深圳)[J]. 中华消化杂志, 2014, 34(2): 73-76.
[8] 中国中西医结合学会消化系统疾病专业委员会. 消化性溃疡中西医结合诊疗共识意见(2011年天津)[J]. 中国中西医结合杂志, 2012, 32(6): 733-737.
[9] Dixon M F, Genta R M, Yardley J H, et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994 [J]. American Journal of Surgical Pathology, 1996, 20(10): 1161-81.
[10] 吴海武, 谢俊锋, 汤建华, 等. 大剂量奥美拉唑治疗老年胃溃疡合并出血的疗效分析[J]. 现代预防医学, 2012, 39(5): 1292-1293.
[11] Boyce M, Dowen S, Turnbull G, et al. Effect of netazepide, a gastrin/ CCK 2, receptor antagonist, on gastric acid secretion and rabeprazole-induced hypergastrinaemia in healthy subjects[J]. British Journal of Clinical Pharmacology, 2015, 79(5): 744-755.
[12] Sahara S, Sugimoto M, Uotani T, et al. Twice-daily dosing of esomeprazole effectively inhibits acid secretion in CYP2C19 rapid metabolisers compared with twice-daily omeprazole, rabeprazole or lansoprazole [J]. Alimentary Pharmacology & Therapeutics, 2013, 38(9): 1129-37.
[13] 黄俊民. 奥美拉唑与雷贝拉唑治疗消化道溃疡临床疗效比较[J].中国现代药物应用, 2015, 9(24): 113-114.
[14] 刘童婷, 黄秀深, 陈瑾, 等. 康复新液对慢性胃溃疡愈合环境和营养的影响[J]. 中成药, 2013, 35(12): 2738-274.
[15] 陆彩霞. 复方谷氨酰胺联合雷贝拉唑治疗幽门螺杆菌阴性十二指肠球部溃疡疗效观察[J].中医临床研究, 2014, 6(32): 122-123.
[16] Malfertheiner P, Fass R, Quigley E M M, et al. Review article: From gastrin to gastro- oesophageal reflux disease- a century of acid suppression [J]. Alimentary Pharmacology & Therapeutics, 2006, 23(6): 683-90.