目的 探討含阿莫西林克拉維酸鉀的鉍劑四聯(lián)方案治療幽門螺桿菌感染致慢性胃炎的臨床療效。方法 選取2020年5月—2021年8月在北京市海淀醫(yī)院消化內(nèi)科接受治療的116例幽門螺桿菌感染致慢性胃炎患者為研究對(duì)象，按照治療方案不同將患者分為對(duì)照組和試驗(yàn)組，每組58例，對(duì)照組給予含阿莫西林的鉍劑四聯(lián)方案治療，試驗(yàn)組給予含阿莫西林克拉維酸鉀的鉍劑四聯(lián)方案治療，兩組均治療14 d。分別于治療前后采用酶聯(lián)免疫吸附（ELISA）法檢測(cè)血清炎癥因子白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、C反應(yīng)蛋白（CRP）、胃動(dòng)素（MTL）、胃泌素（GAS）水平；分別于治療前后采用流式細(xì)胞儀檢測(cè)T淋巴細(xì)胞亞群（CD4⁺、CD8⁺、CD4⁺/CD8⁺）水平的變化；記錄兩組治療總有效率和不良反應(yīng)發(fā)生率。結(jié)果 治療后，對(duì)照組和試驗(yàn)組患者血清IL-6、TNF-α、CRP、GAS、CD8⁺水平較本組治療前均顯著降低（P＜0.05），而MTL、CD4⁺、CD4⁺/CD8⁺水平較本組治療前均顯著升高（P＜0.05），且治療后試驗(yàn)組血清IL-6、TNF-α、CRP、GAS、CD8⁺水平顯著低于對(duì)照組（P＜0.05），MTL、CD4⁺、CD4⁺/CD8⁺水平顯著高于對(duì)照組（P＜0.05）。試驗(yàn)組的總有效率為93.10%，顯著高于對(duì)照組的79.31%（P＜0.05），試驗(yàn)組的不良反應(yīng)發(fā)生率為6.90%，顯著低于對(duì)照組的12.07%（P＜0.05）。結(jié)論 含阿莫西林克拉維酸鉀的鉍劑四聯(lián)方案治療幽門螺桿菌感染致慢性胃炎療效更為顯著，能抑制機(jī)體內(nèi)炎癥反應(yīng)、調(diào)控胃腸道激素分泌，提高患者免疫力，多途徑共同作用促進(jìn)患者病情好轉(zhuǎn)，值得臨床推廣使用。

Objective To explore the clinical efficacy of bismuth quadrupl therapy containing amoxicillin/potassium clavulanate in treatment of chronic gastritis induced by Helicobacter pylori infection. Methods A total of 116 patients with Helicobacter pylori infection-related gastritis who were treated in the Department of Gastroenterology of Beijing Haidian Hospital from May 2020 to August 2021 were selected. According to the different treatment schemes, the patients were divided into control group and experimental group, with 58 cases in each group. Patients in control group were treated with bismuth quadrupl therapy containing amoxicillin, and patients in experimental group were treated with bismuth quadrupl therapy containing amoxicillin/potassium clavulanate. Both patients were treated for 14 days. Serum inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP), motilin (MTL), gastrin (GAS) levels were detected by enzyme-linked immunosorbent assay (ELISA) before and after treatment. The changes of T lymphocyte subsets (CD4⁺, CD8⁺, CD4⁺/CD8⁺) were detected by flow cytometry before and after treatment. The total effective rate and adverse reaction rate of two groups were recorded. Results After treatment, serum IL-6, TNF-α, CRP, GAS, CD8⁺ levels in control group and experimental group were significantly lower than those before treatment (P < 0.05), while MTL, CD4⁺, CD4⁺/CD8⁺ levels were significantly higher than those before treatment (P < 0.05). Serum IL-6, TNF-α, CRP, GAS, CD8⁺ levels in experimental group after treatment were significantly lower than those in control group (P < 0.05), while MTL, CD4⁺, CD4⁺/CD8⁺ levels were significantly higher than those in control group (P < 0.05). The total effective rate of the experimental group was 93.10%, significantly higher than 79.31% of the control group (P < 0.05), and the incidence of adverse reactions in the experimental group was 6.90%, significantly lower than 12.07% of the control group (P < 0.05). Conclusion The bismuth quadrupl therapy containing amoxicillin/potassium clavulanate is more effective in treatment of chronic gastritis caused by Helicobacter pylori infection. It can inhibit the inflammatory reaction in body, regulate the secretion of gastrointestinal hormones, improve the immunity of patients, and promote the improvement of patients' conditions through multiple ways, which is worthy of clinical promotion.

R975