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目的 :针对老年慢性胃炎伴幽门螺杆菌感染分别采用四联疗法和三联疗法,对比其疗效。方法 :选择2013年5月至2016年5月在我院就诊的老年慢性胃炎伴幽门螺杆菌感染60患者按照就诊顺序随机分为四联疗法组和三联疗法组,每组各30例。所有患者均在外院予以胃镜或尿素酶试验或14C-尿素呼气试验证实的慢性胃炎HP阳性患者。三联疗法组采用果胶铋、阿莫西林、甲硝唑治疗疗程2周。四联疗法组在三联疗法基础上加用奥美拉唑,疗程1周。在抗HP治疗结束后4周,作14C-尿素呼气试,比较两种治疗方法效果。结果 :三联疗法组在治疗老年慢性胃炎伴幽门螺杆菌感染中症状缓解率为83.3%,HP根除率为83.3%,不良反应发生率为30%,四联疗法组在治疗老年慢性胃炎伴幽门螺杆菌感染中症状缓解率为86.6%,HP根除率为86.6%,不良反应发生率为26%,两组比较无显著性差异。结论 :四联疗法和三联疗法对于老年慢性胃炎伴幽门螺杆菌感染都具有较好疗效及Hp清除率。而四联疗法因疗程缩短,更经济合理,是较为理想的方案。
Objective: To compare the efficacy of quadruple therapy and triple therapy for chronic gastritis with Helicobacter pylori infection in elderly patients. Methods: 60 elderly patients with chronic gastritis and Helicobacter pylori infection who were treated in our hospital from May 2013 to May 2016 were randomly divided into quadruple therapy group and triple therapy group according to the order of treatment, with 30 patients in each group. All patients underwent gastroscopic or urease tests or chronic gastritis HP positive patients confirmed by 14C-urea breath test. Triple therapy group with pectin bismuth, amoxicillin, metronidazole treatment for 2 weeks. The quadruple therapy group added omeprazole on the basis of triple therapy for one week. Four weeks after the anti-HP treatment was completed, 14C-urea breath test was performed to compare the effects of the two treatment methods. Results: In the triple therapy group, the symptom relief rate was 83.3% in the chronic gastritis with Helicobacter pylori infection, the eradication rate was 83.3% and the adverse reaction rate was 30%. The quadruple therapy group was superior in treating chronic gastritis with pyloric screw Symptoms in bacteria infection was 86.6%, HP eradication rate was 86.6%, the incidence of adverse reactions was 26%, no significant difference between the two groups. Conclusion: The combination of quadruple therapy and triple therapy have good curative effect and Hp clearance rate in senile chronic gastritis with Helicobacter pylori infection. The quadruple therapy shorten the course of treatment, more economical and reasonable, is the ideal solution.