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本文引用的文献

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Giant Gastric Ulcers: An Unusual Culprit.巨大性胃溃疡:一个不寻常的病因。
Dig Dis Sci. 2020 Oct;65(10):2811-2817. doi: 10.1007/s10620-020-06573-z.
2
Randomised clinical trial: tegoprazan, a novel potassium-competitive acid blocker, or lansoprazole in the treatment of gastric ulcer.随机临床试验:替戈拉赞,一种新型钾离子竞争性酸阻滞剂,或兰索拉唑治疗胃溃疡。
Aliment Pharmacol Ther. 2020 Sep;52(5):789-797. doi: 10.1111/apt.15865. Epub 2020 Jul 23.
3
Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline.危重症患者的胃肠道出血预防:临床实践指南。
BMJ. 2020 Jan 6;368:l6722. doi: 10.1136/bmj.l6722.
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Antiulcerogenic effect of Cuphea ignea extract against ethanol-induced gastric ulcer in rats.贯叶连翘提取物抗乙醇诱导大鼠胃溃疡的作用。
BMC Complement Altern Med. 2019 Dec 2;19(1):345. doi: 10.1186/s12906-019-2760-9.
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Changes of gastric ulcer bleeding in the metropolitan area of Japan.日本都市区胃溃疡出血的变化。
World J Gastroenterol. 2019 Nov 14;25(42):6342-6353. doi: 10.3748/wjg.v25.i42.6342.
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Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI].慢性萎缩性胃炎:自然史、诊断和治疗管理。意大利医院胃肠病学家和消化内镜学会 [AIGO]、意大利消化内镜学会 [SIED]、意大利胃肠病学会 [SIGE] 和意大利内科医师学会 [SIMI] 的立场文件。
Dig Liver Dis. 2019 Dec;51(12):1621-1632. doi: 10.1016/j.dld.2019.09.016. Epub 2019 Oct 19.
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Management of uncomplicated gastric ulcer in community pharmacy: a pseudo-patient study.社区药房中非复杂性胃溃疡的管理:一项假性患者研究。
Int J Clin Pharm. 2019 Dec;41(6):1462-1470. doi: 10.1007/s11096-019-00905-4. Epub 2019 Sep 16.
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Potent therapeutic effects of ruscogenin on gastric ulcer established by acetic acid.鲁斯可皂苷元对乙酸致胃溃疡的强效治疗作用。
Asian J Surg. 2020 Feb;43(2):405-416. doi: 10.1016/j.asjsur.2019.07.001. Epub 2019 Jul 22.
9
Prevention of recurrent idiopathic gastroduodenal ulcer bleeding: a double-blind, randomised trial.预防复发性特发性胃十二指肠溃疡出血:一项双盲、随机临床试验。
Gut. 2020 Apr;69(4):652-657. doi: 10.1136/gutjnl-2019-318715. Epub 2019 Jun 22.
10
Effect of Hydrotalcite on Indometacin-Induced Gastric Injury in Rats.水滑石对吲哚美辛诱导的大鼠胃损伤的影响。
Biomed Res Int. 2019 Apr 11;2019:4605748. doi: 10.1155/2019/4605748. eCollection 2019.

碳酸镁铝联合雷贝拉唑三联疗法治疗幽门螺杆菌阳性胃溃疡伴出血的临床观察

Clinical observation of magnesium aluminum carbonate combined with rabeprazole-based triple therapy in the treatment of helicobacter pylori-positive gastric ulcer associated with hemorrhage.

作者信息

Zhou Peng-Zhe, Gao Lei, Wang Li-Wei, Zhang Ying-Fu, Song Wei-Li, Hao Ying-Xia

机构信息

Peng-zhe Zhou, Department of Gastroenterology, Baoding First Central Hospital, Hebei, Baoding, 071000, P. R. China.

Lei Gao, Department of Gastroenterology, Baoding First Central Hospital, Hebei, Baoding, 071000, P. R. China.

出版信息

Pak J Med Sci. 2022 May-Jun;38(5):1271-1277. doi: 10.12669/pjms.38.5.5174.

DOI:10.12669/pjms.38.5.5174
PMID:35799719
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9247804/
Abstract

OBJECTIVES

To evaluate the clinical effect of magnesium aluminum carbonate combined with rabeprazole-based triple therapy in the treatment of patients with Helicobacter pylori-positive gastric ulcer associated with hemorrhage.

METHODS

A total of 80 patients with Helicobacter pylori-positive gastric ulcer associated with hemorrhage admitted to the Baoding First Central Hospital from January 2019 to December 2020 were selected and randomly divided into two groups, with 40 cases in each group. The control group were given rabeprazole-based triple therapy, while the experimental group were treated with magnesium aluminum carbonate on the basis of the control group. The changes of symptoms and signs such as abdominal pain, abdominal distension, nausea, vomiting and hematochezia were compared between the two groups before and after treatment. Serological changes of the gastric mucosal microenvironment, such as the serum levels of extracellular regulatory protein kinase (ERK), superoxide dismutase (SOD) and epidermal growth factor receptor (EGFR), were compared between the two groups. Moreover, the differences in the results of gastroscopy between the two groups before and after treatment were compared and analyzed.

RESULTS

The scores of gastrointestinal symptoms in the experimental group after treatment were significantly improved compared with the control group (p=0.00). The levels of ERK and EGFR in the experimental group were significantly lower than those in the control group (ERK, p=0.01; EGRF, p=0.00), while the level of SOD was significantly increased (p=0.02). After treatment, the total effective rate of ulcer healing in the experimental group was 82.5%, which was significantly better than 60% in the control group (p=0.03). After treatment, moderate to severe gastric mucosal inflammation in the experimental group decreased to 10%, significantly better than that in the control group (decreased to 30%) (p=0.03).

CONCLUSION

Magnesium aluminum carbonate combined with rabeprazole-based triple therapy is preferred for the treatment of patients with Helicobacter pylori-positive gastric ulcer associated with hemorrhage. With such a highly effective treatment regimen, the internal environment and blood supply of gastric mucosal cells can be significantly improved, gastric mucosal inflammation and gastrointestinal symptoms can be ameliorated, and the healing of ulcer surfaces can be accelerated.

摘要

目的

评估碳酸镁铝联合以雷贝拉唑为基础的三联疗法治疗幽门螺杆菌阳性胃溃疡合并出血患者的临床疗效。

方法

选取2019年1月至2020年12月在保定市第一中心医院收治的80例幽门螺杆菌阳性胃溃疡合并出血患者,随机分为两组,每组40例。对照组给予以雷贝拉唑为基础的三联疗法,实验组在对照组基础上加用碳酸镁铝。比较两组治疗前后腹痛、腹胀、恶心、呕吐及便血等症状和体征的变化。比较两组胃黏膜微环境的血清学变化,如细胞外调节蛋白激酶(ERK)、超氧化物歧化酶(SOD)和表皮生长因子受体(EGFR)的血清水平。此外,比较并分析两组治疗前后胃镜检查结果的差异。

结果

治疗后实验组胃肠道症状评分较对照组显著改善(p = 0.00)。实验组ERK和EGFR水平显著低于对照组(ERK,p = 0.01;EGRF,p = 0.00),而SOD水平显著升高(p = 0.02)。治疗后,实验组溃疡愈合总有效率为82.5%,显著优于对照组的60%(p = 0.03)。治疗后,实验组中重度胃黏膜炎症降至10%,显著优于对照组(降至30%)(p = 0.03)。

结论

碳酸镁铝联合以雷贝拉唑为基础的三联疗法是治疗幽门螺杆菌阳性胃溃疡合并出血患者的首选。采用这种高效治疗方案可显著改善胃黏膜细胞的内环境和血液供应,减轻胃黏膜炎症和胃肠道症状,加速溃疡面愈合。