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目的探讨克拉霉素的药理特性及治疗幽门螺杆菌感染的应用,指导消化性溃疡幽门螺杆菌感染的治疗。方法选取2009年4月-2013年12月收治的消化性溃疡患者106例,均为幽门螺杆菌感染所致,将其随机分为两组,各53例,治疗组采用奥美拉唑、阿莫西林联合克拉霉素三联进行治疗,对照组使用奥美拉唑联合阿莫西林进行治疗,比较两组患者的临床疗效及不良反应。结果服药两周后治疗组总有效率、不良反应发生率分别为86.79%、7.55%,对照组分别为69.81%、15.09%,两组比较差异有统计学意义(P<0.05);不良反应症状主要为恶心呕吐、头晕、腹泻;治疗组服药两周后幽门螺杆菌清除率为84.91%,显著高于对照组的67.92%,两组比较差异有统计学意义(P<0.05)。结论克拉霉素主要通过抑制转肽作用和mRNA合成细菌蛋白质发挥抗菌活性,并且在患者体内2~3h可达到血药浓度峰值,可有效治疗消化性溃疡;同时其胃肠道反应低,降低不良反应发生率,值得在临床上推广。
Objective To investigate the pharmacological properties of clarithromycin and the treatment of Helicobacter pylori infection and to guide the treatment of peptic ulcer with Helicobacter pylori infection. Methods A total of 106 patients with peptic ulcer were selected from April 2009 to December 2013, all of them were caused by Helicobacter pylori infection. They were randomly divided into two groups of 53 patients each. The treatment group was omeprazole In the control group, omeprazole and amoxicillin were used for treatment. The clinical efficacy and adverse reactions of the two groups were compared. Results The total effective rate and adverse reaction rate in the treatment group after treatment for two weeks were 86.79% and 7.55%, respectively, which were respectively 69.81% and 15.09% in the control group, with significant difference between the two groups (P <0.05) Mainly nausea and vomiting, dizziness, diarrhea; treatment group two weeks after taking H. pylori clearance rate was 84.91%, significantly higher than 67.92% of the control group, the difference between the two groups was statistically significant (P <0.05). Conclusion Clarithromycin can exert antibacterial activity mainly through inhibiting the function of transpeptidase and mRNA synthesis of bacterial protein, and can reach the peak of plasma concentration in patients within 2 ~ 3h, which can effectively treat peptic ulcer; The incidence of the reaction, it is worth in the clinical promotion.