埃索美拉唑、左氧氟沙星和奥硝唑联用治疗慢性胃炎的临床疗效及其炎症反应分析

胡志方

【摘要】 目的 分析對慢性胃炎使用埃索美拉唑、左氧氟沙星和奥硝唑联用治疗的效果。方法 60例慢性胃炎患者， 随机分为观察组（31例）和对照组（29例）。对照组患者采用埃索美拉唑、阿莫西林和克拉霉素治疗， 观察组患者采用埃索美拉唑、左氧氟沙星和奥硝唑联用治疗。比较两组治疗前后肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）、白细胞介素-6（IL-6）水平;治疗效果;幽门螺杆菌清除率、幽门螺杆菌清除时间、复发率和治疗成本;不良反应发生情况。结果 治疗后， 两组患者TNF-α、IL-8、IL-6水平均低于本组治疗前， 且观察组患者TNF-α、IL-8、IL-6水平均低于对照组， 差异均具有统计学意义（P<0.05）。观察组患者的治疗总有效率87.10%显著高于对照组的62.07%， 差异具有统计学意义（P<0.05）。观察组幽门螺杆菌清除率100.00%高于对照组的79.31%， 复发率3.23%低于对照组的24.14%， 幽门螺杆菌清除时间（4.48±1.06）d短于对照组的（6.92±2.13）d， 差异均具有统计学意义（P<0.05）;两组治疗成本比较差异无统计学意义（P>0.05）。观察组患者的不良反应发生率为6.45%， 显著低于对照组的27.59%， 差异具有统计学意义（P<0.05）。结论 慢性胃炎患者使用埃索美拉唑、左氧氟沙星和奥硝唑联用治疗， 可以有效减轻炎症， 有效的清除幽门螺杆菌， 治疗效果显著， 安全性高， 复发率低， 疗效确切， 具有临床应用的价值。

【关键词】 慢性胃炎;幽门螺杆菌;埃索美拉唑;左氧氟沙星;奥硝唑;炎症反应

DOI：10.14163/j.cnki.11-5547/r.2020.20.009

【Abstract】 Objective   To analyze the therapeutic effect of esomeprazole and levofloxacin combined with ornidazole in the treatment of chronic gastritis. Methods   A total of 60 chronic gastritis patients were randomly divided into observation group （31 cases） and control group （29 cases）. The control group was treated by esomeprazole and amoxicillin combined with clarithromycin， and the observation group was treated by esomeprazole and levofloxacin combined with ornidazole. The tumor necrosis factor-α （TNF-α）， interleukin-8 （IL-8）， interleukin-6 （IL-6） levels before and after treatment， therapeutic effect， Helicobacter pylori clearance rate， Helicobacter pylori clearance time， recurrence rate and treatment cost and occurrence of adverse reactions were compared between the two groups. Results   After treatment， the levels of TNF-α， IL-8 and IL-6 of the two groups were lower than those before treatment， and the the levels of TNF-α， IL-8 and IL-6 of the observation group were lower than those of the control group， and the difference was statistically significant （P<0.05）. The total effective rate of treatment 87.10% of the observation group was significantly higher than that of the control group 62.07%， and the difference was statistically significant （P<0.05）. The Helicobacter pylori clearance rate 100.00% of the observation group was higher than that of the control group 79.31%， recurrence rate 3.23% was lower than that of the control group， and Helicobacter pylori clearance time （4.48±1.06） d was shorter than that of the control group （6.92±2.13） d. The difference was statistically significant （P<0.05）. There was no statistically significant difference in treatment cost between the two groups （P>0.05）. The incidence of adverse reactions of the observation group was 6.45%， which was significantly lower than that of the control group 27.59%， and the difference was statistically significant （P<0.05）. Conclusion   Esomeprazole and levofloxacin combined with ornidazole shows remarkable effect in the treatment of chronic gastritis patients， which can effectively reduce inflammation and eliminate Helicobacter pylori with high safety， low recurrence rate and definite curative effect. It has clinical application value.

【Key words】 Chronic gastritis; Helicobacter pylori; Esomeprazole; Levofloxacin; Ornidazole; Inflammatory response

由于饮食改变， 内分泌失调、压力大、作息不规律、幽门螺杆菌感染等原因， 使得慢性胃炎的发病率越来越高， 临床主要表现为胃痛、反酸、恶心呕吐、胃胀等[1]。慢性胃炎根据慢性胃炎在内镜下的表现可以分为慢性萎缩性胃炎和慢性非萎缩性胃炎[2]。根据是否存在幽门螺杆菌感染可以分为幽门螺杆菌相关性胃炎和非幽门螺杆菌相关性胃炎， 此外还有应用非甾体类消炎药相关的胃炎、自身免疫性胃炎和嗜酸细胞性胃炎[3]。在慢性胃炎中多为幽门螺杆菌相关性胃炎， 因此临床治疗以根除幽门螺杆菌为主。药物治疗是常用的治疗方法， 西药抗生素是常用的药物， 但是药物治疗效果不彻底， 经常反复发作， 影响患者的生活。……