目的 探讨瑞巴派特片对治疗幽门螺杆菌(helicobacter pylori,Hp)阳性消化性溃疡效果与复发的影响。方法 选取2018-10至2019-09武警北京总队医院接收治疗的Hp阳性消化性溃疡患者110例为研究对象,其中采用常规四联除菌治疗患者62例为对照组,在常规四联除菌基础上服用瑞巴派特片治疗患者48例为研究组,两组患者均连续治疗2周。治疗结束后,比较两组Hp根除率和疗效。治疗后两组患者均随访至少6个月,统计随访期间Hp阳性例数并计算Hp复发率。检测比较两组治疗前和治疗2周的血清白介素(IL)-6、肿瘤坏死因子(TNF)-α、C反应蛋白(CRP)等炎性因子水平,以及红细胞压积、红细胞聚集指数、血浆黏度与红细胞沉降率等血液流变学指标水平。比较两组不良反应发生率。结果 研究组治疗有效率和Hp根除率分别为95.83%和95.83%,高于对照组的80.65%和82.26%;研究组Hp复发率为10.87%,低于对照组的27.45%(P<0.05)。研究组治疗2周的血清IL-6[(9.11±1.66)ng/L]、TNF-α值[(1.25±0.25)μg/L]、CRP值[(3.55±1.06)mg/L]均低于对照组血清IL-6[(13.74±2.03) ng/L]、TNF-α值[(2.17±0.34)μg/L]和CRP值[(5.26±1.43)mg/L],差异有统计学意义(P<0.05)。与同组治疗前比较,两组治疗2周的血清IL-6、TNF-α和CRP水平、红细胞压积、红细胞聚集指数、血浆黏度与红细胞沉降率均降低(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论 瑞巴派特片辅助常规四联除菌治疗Hp阳性消化性溃疡疗效和安全性良好,可改善血液流变学、减轻炎性反应并预防Hp复发,值得临床推广应用。

Objective To investigate the influence of ribapamide on the therapeutic effect and recurrence of helicobacter pylori (HP) - positive peptic ulcer. Methods Between October 2018 and September 2019, 110 patients with Helicobacter pylori positive peptic ulcer admitted to Beijing Municipal Corps Hospital of PAP were selected as the subjects. Sixty-two of these patients were treated with conventional quadruple sterilization and included in the control group, while the rest were additionally treated with ribapamide and included in the study group. Both groups were treated for two consecutive weeks. After treatment, the HP eradication rate and the therapeutic effect were detected and compared between the two groups. After treatment, patients in both groups were followed up for a minimum of six months. The number of HP positive cases during follow-up and the HP recurrence rate of the two groups were calculated. The serum levels of IL-6, TNF-a and CRP and other inflammation factors, hematocrit, RBC aggregation index, plasma viscosity and erythrocyte sedimentation rate and other hemorheological indexes before treatment and two weeks after treatment were measured and compared between the two groups. The rate of adverse reactions or complications was also compared between the two groups. Results The effective rate and eradication rate of HP in the study group were 95.83% and 95.83% respectively, which were higher than 80.65% and 82.26% in the control group. The recurrence rate of HP in the study group was 10.87%, which was lower than 27.45% in the control group (P<0.05). After two weeks of treatment, the serum IL-6 value was (9.11±1.66)ng/L, TNF-α value(1.25±0.25)μg/L and CRP value was(3.55±1.06)mg/L in the study group, compared to(13.74±2.03)ng/L,(2.17±0.34)μg/L and(5.26±1.43)mg/L in the control group, so the difference was statistically significant (P<0.05). After two weeks of treatment, serum levels of IL-6, TNF-α and CRP, hematocrit, erythrocyte aggregation index, plasma viscosity and erythrocyte sedimentation rate of the two groups decreased (P<0.05). There was no significant difference in the rate of adverse reactions or complications between the two groups. Conclusions The efficacy and safety of rebamipide tablets combined with conventional quadruple sterilization in the treatment of Hp-positive peptic ulcer are satisfactory, which can improve hemorheology, alleviate inflammatory reactions and prevent Hp recurrence. This approach should be made accessible.