【摘要】 目的：对比观察二联疗法与四联疗法根除幽门螺杆菌(Helicobacter pylori,Hp)对Hp胃炎患者消化系统症状的影响。方法：纳入131例接受Hp根除治疗的Hp胃炎患者，随机分至高剂量二联疗法组、四联疗法组进行治疗，根据Hp治愈情况，又各分为成功组、失败组，随访其根除治疗前、停药1周，停药1月，停药半年的胃食管反流病症状频率表、胃食管返流病自测表、利兹消化不良问卷、胃肠道症状评定量表、胃肠道症状积分问卷得分变化。结果：按意向性分析，二联疗法组与四联疗法组根除率分别为83.1%、86.7%，两组比较差异无统计学意义（P>0.05）;Hp根除成功组中，两种Hp根除治疗法均改善了Hp胃炎患者腹痛、反流、消化不良的消化系统症状，该影响可持续至治疗后半年。Hp治疗失败时，反流症状同样会得到缓解，二联疗法较四联疗法缓解持续时间更长（半年vs1月），但消化不良症状无减轻；Hp根除治疗成功与否对腹泻、便秘症状无影响。结论：Hp根除治疗可减轻Hp胃炎患者消化道症状，以上消化道症状为主，在Hp根除成功组，二联疗法与四联疗法对患者消化系统症状影响一致，在Hp根除失败患者中，二联疗法较四联疗法对Hp胃炎患者反流症状缓解持续时间更长。更多还原

【Abstract】 Objective:To compare the effects of dual therapy group and Bismuth-containing quadruple therapy on the digestive system symptoms of patients with Helicobacter pylori gastritis.Methods:131 patients with Helicobacter pylori gastritis treated with Hp eradication were included, They were randomly divided into PPI-amoxicillin dual therapy group and Bismuth-containing quadruple therapy group.According to the cure of Helicobacter pylori,they were divided into success group,and failure group respectively,They were followed up before eradication,1 week,1 month and half a year.The symptom frequency table of gastroesophageal reflux disease(FSSG),gastroesophageal reflux disease questionnaire(Gerd Q) and Leeds dyspepsia questionnaire(LDQ) Gastrointestinal Symptom Rating Scale(GSRS),gastrointestinal symptom score questionnaire(GIS) were used.Results:According to intention-to-treat analysis,the eradication rates of the dual therapy group were 83.1% and 86.7%,respectively,and the difference was not statistically significant(P >0.05).Hp eradication was successful.Regardless of dual therapy or quadruple therapy,Hp eradication therapy improved the digestive symptoms of abdominal pain,dyspepsia in patients with Hp gastritis,and this effect could last until half a year after treatment.When Hp treatment fails,the symptoms will also be relieved,and the duration of remission with dual therapy is longer than that with quadruple therapy(half a year vs.1 month),but the symptoms of dyspepsia are not relieved.The success of Hp eradication therapy had no effect on the symptoms of diarrhea and constipation.Conclusion:Hp eradication treatment can reduce the digestive tract symptoms of patients with Hp gastritis,mainly the above gastrointestinal symptoms.In the successful Hp eradication group,the effect of dual therapy group and Bismuth-containing quadruple therapy on the digestive system symptoms of patients is the same.In the patients with failed Hp eradication,the two combination therapy has a longer relief duration of reflux symptoms of patients with Hp gastritis than four combination therapy.更多还原