幽门螺杆菌与消化性溃疡并出血的研究现状

Clinical effects of esomeprazole, amoxicillin and clarithromycin combined with traditional Chinese medicine decoction in treatment of peptic ulcer bleeding

AIM: To assess the clinical effects of esomeprazole magnesium enteric-coated tablets, amoxicillin capsules and clarithromycin capsules combined with traditional Chinese medicine decoction in the treatment of peptic ulcer bleeding (PUB).

METHODS: Ninety-six patients with PUB were divided into either a traditional Chinese medicine plus Western medicine group (n = 61) or a Western medicine alone group (n = 35) according to the medications. The Western medicine alone group was treated with esomeprazole magnesium enteric-coated tablets + amoxicillin capsules + clarithromycin capsules, and the combination group was additionally given traditional Chinese medicine decoction on the basis of Western medicine treatment. The hemostasis time, total symptom score, Helicobacter pylori (H. pylori) eradication rate and clinical effects were compared for the two groups.

RESULTS: The total symptom scores for the two groups were significantly lower after treatment than prior treatment (10.62 ± 2.53 vs 33.50 ± 2.91, 17.30 ± 1.98 vs 32.25 ± 2.48, P < 0.05). The hemostasis time and total symptom score in the combination group were significantly lower than those in the Western medicine alone group (3.02 d ± 1.48 d vs 4.48 d ± 1.72 d, 10.62 ± 2.53 vs 17.30 ± 1.98, P < 0.05). The H. pylori eradication rate in the combination group was higher than that in the Western medicine alone group (93.44% vs 80.00%, P < 0.05). The cure rate and total effective rate were significantly higher in the combination group than in the Western medicine alone group (59.02% vs 34.29%, 93.44% vs 82.86%, P < 0.05).

CONCLUSION: Esomeprazole, amoxicillin and clarithromycin combined with traditional Chinese medicine decoction can improve clinical symptoms, shorten hemostasis time, increase H. pylori eradication rate and improve clinical effects in patients with PUB.

Clinical effect of small dose clarithromycin-based triple therapy in treatment of children peptic ulcer

AIM: To observe the clinical effect and safety of small dose clarithromycin (CLA)-based triple therapy in the treatment of children peptic ulcer (PU).

METHODS: Seventy-five children with PU were divided into three groups to receive small dose CLA-based triple therapy (A), large dose CLA-based triple therapy (B) and amoxicillin-based triple therapy (C). After treatment, abdominal pain relief, rate of Helicobacter pylori (H. pylori) eradication and adverse reactions were observed and compared among the three groups.

RESULTS: Three days after treatment, pain score declined obviously in all three groups. Two weeks after treatment, abdominal pain was relieved in all children. The rate of H. pylori eradication did not differ significantly between groups A, B and C (96.0%, 96.0%, 92.0%, all P > 0.05). The effective rate was significantly higher in groups A and B than in group C (92.0%, 88.0% vs 72.0%, both P < 0.05), but showed no significant difference between groups A and B (P > 0.05). The rate of adverse reactions (mainly nausea, vomiting, poor appetite and mild diarrhea) was significantly lower in group A than in groups B and C (8.0% vs 20.0%, 24.0%, both P < 0.05).

CONCLUSION: Although all three types of therapy possess a high rate of H. pylori eradication and can quickly relieve abdominal pain, small dose CLA-based triple therapy has a lower rate of adverse reactions and therefore can be used as the first choice of treatment for children PU.

Prevalence of and risk factors for Helicobacter pylori infection in patients who underwent gastroscopy from 2010 to 2012 in Liupanshui city

AIM: To investigate the prevalence of and risk factors for Helicobacter pylori (H. pylori) infection in patients who underwent gastroscopy from 2010 to 2012 in Liupanshui city and to discuss its preventive strategies.

METHODS: A total of 59524 patients who underwent endoscopy from 2010 to 2012 in Liupanshui were retrospectively analyzed to investigate the prevalence of and risk factors for H. pylori infection.

RESULTS: The positive rate of H. pylori increased gradually with age. The positive rates of H. pylori in different gastric lesions were different. Ulcer disease, gastric cancer and chronic atrophic gastritis had significantly higher positive rates (χ² = 12.41, P< 0.05). The risk factors for H. pylori infection included age (β = 0.679, S.E.= 0.334, Wald = 14.203, OR = 1.989, P < 0.05), gender (β = 0.564, S.E. = 0.432, Wald = 16.353, OR = 1.868, P < 0.05), diet (β = 0.546, S.E. = 0.449, Wald = 17.293, OR = 1.787, P < 0.05), drinking habit (β = 0.673, S.E.= 0.308, Wald = 15.203, OR = 1.592, P < 0.05), family size (β = 0.599, S.E. = 0.364, Wald = 18.727, OR = 1.329, P < 0.05), living conditions (β = 0.653, S.E.= 0.362, Wald = 15.363, OR = 1.363, P < 0.05), and rearing animals (β = 0.692, S.E. = 0.388, Wald = 15.305, OR = 1.565, P < 0.05).

CONCLUSION: The positive rate of H. pylori infection in patients who underwent gastroscopy in Liupanshui is high, suggesting that H. pylori infection is closely related with the occurrence of gastric ulcer and gastric cancer.

Safety of fast-track gastrointestinal surgery in elderly patients

AIM: To evaluate the safety of fast-track gastrointestinal surgery in elderly patients and explore the principle of individualization.

METHODS: Three hundred and sixty patients who underwent gastrointestinal surgery from January 2009 to January 2012 at our hospital were included in this study, of whom 180 received fast-track surgery and 180 underwent traditional surgery. The incidence and severity of complications were compared between the two groups of patients.

RESULTS: The incidences of individual complications and overall complications were lower in the fast-track surgery group than in the control group, but the differences were not significant. The incidence of gastrointestinal fistula had a gradually increasing trend in the fast-track surgery group. The incidence of general complications was significantly lower in the observation than in the control group (6.67% vs 13.33%, P < 0.05). The incidence of other complications was also significantly lower in the fast-track surgery group than in the control group (P < 0.05).

CONCLUSION: Fast-track surgery can effectively reduce the incidence of gastrointestinal complications; however, improper care may increase the incidence of gastrointestinal fistula.