目的 探究瑞巴派特聯(lián)合鉍劑四聯(lián)療法治療幽門螺桿菌（Hp）陽性胃潰瘍的臨床效果。方法 選取2020年7月—2022年7月廣西壯族自治區(qū)胸科醫(yī)院收治的112例Hp陽性胃潰瘍患者，隨機(jī)分為對照組和治療組，每組各56例。對照組給予鉍劑四聯(lián)療法，泮托拉唑鈉腸溶片40 mg/次，2次/d；阿莫西林克拉維酸鉀片1 g/次，2次/d；克拉霉素片500 mg/次，2次/d；枸櫞酸鉍鉀膠囊0.3 g/次，3次/d。治療組在對照組基礎(chǔ)上口服瑞巴派特片，0.1 g/次，3次/d。兩組均在治療2周后停用抗生素，治療時(shí)間均為4周。觀察兩組患者臨床療效，比較治療前后兩組患者Hp根除率，胃黏膜形態(tài)學(xué)指標(biāo)，及血清干擾素-γ（IFN-γ）、白細(xì)胞介素-2（IL-2）、IL-4和IL-5水平。結(jié)果 治療后，治療組臨床有效率（98.22%）和Hp根除率（98.22%）均分別顯著高于對照組（87.50%，85.71%，P<0.05）。治療后，兩組患者胃黏膜形態(tài)學(xué)指標(biāo)評分均較治療前降低（P<0.05），且治療組慢性炎癥細(xì)胞、腺體密度及黏膜后厚度評分均低于對照組（P<0.05）。治療后，兩組患者血清IFN-γ、IL-2水平均較治療前降低，而血清IL-4、IL-5水平均較治療前升高（P<0.05），且治療組明顯好于對照組（P<0.05）。結(jié)論 瑞巴派特聯(lián)合四聯(lián)療法是Hp陽性胃潰瘍有效且安全的治療方案，能減輕患者胃黏膜損害程度，糾正Th1/Th2免疫失衡。

Objective To explore the clinical effect of rebamipide combined with bismuth quadruple therapy in treatment of Hp positive gastric ulcer. Methods Patients (112 cases) with Hp positive gastric ulcer in Guangxi Zhuang Autonomous Region Chest Hospital from July 2020 to July 2022 were randomly divided into control and treatment group, and each group had 56 cases. Patients in the control group were given bismuth quadruple therapy, including Pantoprazole Sodium Enteric-Coated Tablets 40 mg/time, twice daily, Amoxicillin and Clavulanate Potassium Tablets 1 g/time, twice daily, Clarithromycin Tablets 500 mg/time, twice daily, Bismuth Potassium Citrate Capsules 0.3 g/time, three times daily. Patients in the treatment group were po administered with Rebamipide Tablets on the basis of the control group, 0.1 g/time, three times daily. Patients in two groups stopped using antibiotics after 2 weeks of treatment, and the treatment time was 4 weeks. After treatment, the clinical evaluation was evaluated, and the eradication rate of Hp, morphological indexes of gastric mucosa, and the levels of serum IFN-γ, IL-2, IL-4 and IL-5 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate (98.22%) and Hp eradication rate (98.22%) in the treatment group were significantly higher than those in the control group (87.50%, 85.71%, P < 0.05). After treatment, the morphological indexes of gastric mucosa in two groups were lower than those before treatment (P < 0.05), and the scores of chronic inflammatory cells, gland density and retromucosal thickness in the treatment group were lower than those in the control group (P < 0.05). After treatment, the levels of serum IFN-γ and IL-2 were significantly decreased, while the levels of serum IL-4 and IL-5 were significantly increased in two groups (P< 0.05), and which in the treatment group were significantly better than those the control group (P < 0.05). Conclusion Rebamipide combined with bismuth quadruple therapy is an effective and safe treatment for Hp positive gastric ulcer, which can reduce the degree of gastric mucosal damage and correct the immune imbalance of Th1/Th2.

R975

廣西壯族自治區(qū)衛(wèi)生健康委員會(huì)科研項(xiàng)目（Z20200892）