目的 分析瑞巴派特聯(lián)合三聯(lián)療法治療老年消化性胃潰瘍的臨床效果。方法 回顧2014年6月-2015年10月到北海市中醫(yī)醫(yī)院診治的消化性胃潰瘍的老年患者共96例，按照隨機(jī)原則分為兩組，對照組48例患者采用雷貝拉唑、阿莫西林及克拉霉素三聯(lián)療法，觀察組48例患者在此基礎(chǔ)上加用瑞巴派特輔助治療，比較兩組患者療效，觀察兩組患者治療后1年復(fù)發(fā)情況，記錄治療后噯氣、反酸、腹痛及惡心等臨床癥狀緩解時間，檢測治療前后胃黏膜前列腺素E2（PGE2）水平、轉(zhuǎn)化生長因子β1（TGF-β1）、白介素-17（IL-17）及白介素-25（IL-25）等炎癥因子水平，觀察治療期間口干、腹脹、便秘及皮膚瘙癢等不良反應(yīng)發(fā)生情況。結(jié)果 觀察組患者治療總有效率達(dá)97.92%，顯著高于對照組患者的81.25%（P<0.05）；治療后1年觀察組患者復(fù)發(fā)率僅8.33%，顯著低于對照組患者的31.25%（P<0.05）；治療后噯氣、反酸、腹痛及惡心等臨床癥狀緩解時間均顯著短于對照組患者（P<0.05）。兩組患者治療前黏膜厚度、腺體密度、活動性炎癥細(xì)胞浸潤及慢性炎癥細(xì)胞浸潤等胃黏膜形態(tài)學(xué)評分未表現(xiàn)出明顯差異；治療后兩組以上指標(biāo)均較治療前明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組患者降低幅度均明顯大于對照組患者，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者治療前胃黏膜PGE2、TGF-β1、IL-17及IL-25等炎癥因子水平未表現(xiàn)出明顯差異；治療后兩組以上指標(biāo)均較治療前明顯改善，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組患者治療后胃黏膜PGE2水平明顯高于對照組患者，TGF-β1、IL-17及IL-25等炎癥因子水平均明顯低于對照組患者，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組患者治療期間口干、腹脹、便秘及皮膚瘙癢等不良反應(yīng)發(fā)生率未表現(xiàn)出明顯差異。結(jié)論 瑞巴派特聯(lián)合三聯(lián)療法治療老年消化性胃潰瘍臨床療效確切，能夠有效改善胃黏膜形態(tài)學(xué)，降低復(fù)發(fā)率，建議臨床推廣應(yīng)用。

Objective To analyze the clinical efficacy of rebamipide adjuvant therapy for elderly peptic gastric ulcer.Methods 96 elderly patients diagnosed with peptic gastric ulcer in our hospital from June 2014 to October 2015 were involved in this research.They were randomly divided into two groups.48 patients in control group were treated with triple therapy of rabeprazole,amoxicillin and clarithromycin,and 48 patients in observation group were treated with rebamipide based on the therapy of control group.Efficacy was compared in two groups.Results Total effective rate in observation group was significantly higher than that in control group,recurrence rate at 1 year was obviously lower compared to control group,and remission time of belching,acid reflux,stomachache and nausea after treatment were significantly shorter than those in control group (P<0.05).After treatment,scores of mucous membrane thickness,glandular density,active inflammatory cell infiltration and chronic inflammatory cell infiltration in observation group were significantly lower than those in control group,level of gastric mucosa PGE2 was obviously higher compared to control group,and levels of TGF-β1,IL-17 and IL-25 were significantly lower than those in control group (P<0.05).Adverse reaction incidences of dry mouth,abdominal distension,constipation and skin itching in two groups during treatment showed no significant difference.Conclusion Rebamipide adjuvant therapy is effective for elderly peptic gastric ulcer,which can improve gastric mucosa morphology and reduce recurrence rate,and recommend clinical popularization and application.