替普瑞酮对幽门螺旋杆菌感染相关老年消化性溃疡临床疗效.doc

替普瑞酮对幽门螺旋杆菌感染相关老年消化性溃疡的临床疗效 　　[摘要] 目的 探讨替普瑞酮对幽门螺旋杆菌（Hp）感染相关老年消化性溃疡的临床疗效。 方法 选取2013年6月～2014年12月来河北省老年病医院就诊治疗的72例Hp感染相关性老年消化性溃疡患者作为研究对象，将其随机分为干预组和对照组。干预组给予替普瑞酮联合雷贝拉唑三联疗法，对照组给予雷贝拉唑三联疗法加用安慰剂。观察两组临床疗效、Hp根除及不良反应发生情况。 结果 干预组0～4、5～24周时临床治疗总有效率分别为97.30%（36/37）、85.71%（30/35），明显高于对照组[78.13%（25/32）、60.00%（18/30）]，差异有统计学意义（P 0.05）。 结论 替普瑞酮联合雷贝拉唑三联疗法可明显提高Hp相关老年消化性溃疡的临床疗效，且安全性高 [关键词] 替普瑞酮；老年；消化性溃疡；幽门螺旋杆菌；疗效 [中图分类号] R573.1 [文献标识码] A [文章编号] 1674-4721（2016）09（b）-0140-04 [Abstract] Objective To evaluate the clinical efficacy of Teprenone for helicobacter pylori （Hp） associated elderly peptic ulcer. Methods Seventy-two cases of patients with Hp associated elderly peptic ulcer treated in Hebei Province Geriatric Hospital from June 2013 to December 2014 were selected as research objects， and they were randomly divided into intervention group and control group. The intervention group was given Teprenone combined with Rabeprazole-base triple therapy. Control group was given Rabeprazole-base triple therapy combined with placebo. The clinical effect， Hp eradicating and adverse reactions between the two groups were observed. Results The clinical total effective rate at 0-4， 5-24 weeks in the intervention group was 97.30% （36/37）， 85.71% （30/35） respectively， which were higher than those of control group [78.13% （25/32）， 60.00% （18/30）]， the differences were statistically significant （P 0.05）. Conclusion Teprenone combined with Rabeprazole-base triple therapy can obviously improve the clinical effect of Hp associated peptic ulcer in the elderly， with high safety. 　　[Key words] Teprenone； Elderly； Peptic ulcer； Helicobacter pylori； Efficacy 近年来，消化性溃疡患病率在全世界范围内呈下降趋势，相反老年患者住院和死亡率依然居高不下[1]。老年消化性溃疡是指由于幽门螺旋杆菌（helicobacter pylori，Hp）、服用非甾体类抗炎药物、抽烟、饮酒等引起60岁以上老年人患有的胃溃疡，属于一种特殊类型的消化性溃疡[2]。发病机制不尽相同，目前可根据导致溃疡发生的病因将溃疡分为三类：Hp相关性溃疡、非甾体类抗炎药物相关性溃疡和非Hp非甾体类药物性溃疡。近些年来发现Hp感染是老年消化性溃疡发病机制中的重要环节，根除Hp是溃疡愈合及预防复发的有效治疗措施[3]。张万岱等[4]报道中国自然人群Hp的感染率约为54.76%。随着Hp根除治疗的广泛开展，Hp根除率也随之下降，对抗生素耐药是导致根除治疗失败的最主要原因[5]，包括Ma