富马酸伏诺拉生联合目标性健康教育干预治疗Hp阳性慢性萎缩性胃炎的疗效

孙利红; 孔芳芳; 赵琦; 潘建锋; 裴静波

doi:10.16766/j.cnki.issn.1674-4152.002907

富马酸伏诺拉生联合目标性健康教育干预治疗Hp阳性慢性萎缩性胃炎的疗效

doi: 10.16766/j.cnki.issn.1674-4152.002907

浙江中医药大学附属江南医院消化内科，浙江杭州 311201

基金项目:

浙江省中医药科学研究基金项目 2021ZB241

详细信息

通讯作者:
裴静波, E-mail：jbpei@163.com

中图分类号: R573.32 R473.57
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出版历程
- 收稿日期: 2022-10-29
- 网络出版日期: 2023-04-19

Effectiveness and compliance analysis of vonoprazan fumarate combined with targeted health education intervention on patients with chronic atrophic gastritis with positive Helicobacter pylori

Department of Gastroenterology, Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang 311201, China

摘要

摘要: 目的分析富马酸伏诺拉生联合目标性健康教育干预疗法对幽门螺杆菌(Hp)阳性慢性萎缩性胃炎患者Hp根除率、胃肠激素及治疗依从性的影响。方法选取2020年1月—2022年9月浙江中医药大学附属江南医院收治的Hp阳性慢性萎缩性胃炎患者90例，按照治疗方法分为观察组和对照组，每组45例。2组患者均接受阿莫西林+胶体果胶铋+克拉霉素治疗，对照组同时采用奥美拉唑治疗以清除Hp，并接受常规护理干预，观察组接受富马酸伏诺拉生治疗联合目标性健康教育干预。比较2组患者治疗8周后的临床疗效，Hp清除情况，治疗前后血清胃动素(MLT)、胃泌素17(GAS-17)、胃蛋白酶原水平变化及治疗依从性。结果对照组治疗总有效率为77.78%(35/45)，明显低于观察组的100.00%(45/45)，P＜0.05；对照组Hp清除率为68.89%(31/45)，观察组Hp清除率为84.44%(38/45), 观察组患者的Hp清除率明显高于对照组(P＜0.05)；治疗后，2组患者的MLT、GAS-17、胃蛋白酶原比较差异均有统计学意义(均P＜0.05)，2组上述指标相比治疗前均明显改善(均P＜0.05)；观察组不良反应发生率为4.44%(2/45)，与对照组的8.89%(4/45)相比差异无统计学意义(P＞0.05)；观察组的依从率为97.78%(44/45)，显著高于对照组的75.56%(34/45)，P＜0.05。结论富马酸伏诺拉生联合目标性健康教育干预有助于根治Hp阳性慢性萎缩性胃炎患者的Hp感染，改善MLT、GAS-17及胃蛋白酶原表达水平，提高治疗依从性，安全性较好。
- 富马酸伏诺拉生 /
- 幽门螺杆菌阳性慢性萎缩性胃炎 /
- 胃动素 /
- 胃泌素17 /
- 胃蛋白酶原
Abstract: Objective To explore the effects of vonoprazan fumarate combined with targeted health education intervention on Helicobacter pylori (Hp) eradication rate, gastrointestinal hormones and treatment compliance in patients with Hp positive chronic atrophic gastritis. Methods As a retrospective cohort study, 90 patients with Hp-positive chronic atrophic gastritis admitted to our hospital from January 2020 to September 2022 were selected and divided into observation group and control group according to treatment methods, with 45 patients in each group. Patients in both groups were treated with amoxicillin + pectin ingot + clarithromycin. Patients in the control group were treated with omeprazole to clear Hp and received routine nursing intervention. Patients in the observation group were treated with vonoprazan fumarate combined with targeted health education intervention. The clinical efficacy and Hp clearance after 8 weeks of treatment, the changes of serum motilin (MLT), gastrin 17 (GAS-17) and pepsinogen levels before and after treatment, and the influence of treatment compliance were observed in the two groups. Results The total effective rate of treatment in the control group was 77.78% (35/45), which was significantly lower than that in the observation group [100.00%(45/45), P < 0.05]. The Hp clearance rate in the observation group was 84.44% (38/45), which was significantly higher than that in the control group [68.89% (31/45), P < 0.05)]. After treatment, After treatment, there were statistically significant differences in MLT, GAS-17 and pepsinogen between the two groups (all P < 0.05), the above indexes in the two groups were significantly improved compared with those before treatment (all P < 0.05). The incidence of adverse reactions in the observation group was 4.44% (2/45), which was not significantly different from 8.89% (4/45) in the control group (P > 0.05). The compliance rate of the observation group was 97.78% (44/45), which was significantly higher than 75.56% (34/45) of the control group (P < 0.05). Conclusion Vonoprazan fumarate combined with targeted health education intervention can help to cure Hp infection in patients with Hp positive chronic atrophic gastritis, improve the expression levels of motilin, gastrin 17 and pepsin, and improve treatment compliance, with good safety.
- Vonoprazan fumarate /
- Helicobacter pylori positive chronic atrophic gastritis /
- Motilin /
- Gastrin 17 /
- Pepsinogen

HTML全文

图 1 慢性萎缩性胃炎治疗前后胃镜及病理检验结果

注：A~C为治疗前，D~F为治疗后；C、F为病理活检图(PAS染色，×200)。

Figure 1. Results of gastroscopy and pathological examination before and after treatment of chronic atrophic gastritis

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表 1 2组Hp阳性慢性萎缩性胃炎患者总有效率比较

Table 1. Comparison of total effective rates in two groups of HP-positive patients with chronic atrophic gastritis

组别	例数	痊愈(例)	有效(例)	显效(例)	无效(例)	总有效率(%)
观察组	45	13	18	14	0	100.00(45/45)
对照组	45	8	15	12	10	77.78(35/45)
注：2组总有效率比较，χ²=10.862，P=0.001。

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表 2 2组Hp阳性慢性萎缩性胃炎患者治疗前后血清MLT、GAS-17表达水平比较(x±s)

Table 2. Comparison of serum MLT and GAS-17 expression levels before and after treatment in patients with HP-positive chronic atrophic gastritis in the two groups(x±s)

组别	例数	MLT(ng/L)		GAS-17(mmol/L)
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	45	143.78±21.23	183.72±19.26^a	5.76±1.04	7.85±1.12^a
对照组	45	138.29±22.14	174.23±19.95^a	5.81±1.09	7.08±1.21^a
t值		1.201	2.296	0.223	3.429
P值		0.233	0.024	0.824	0.002
注：与同组治疗前比较，^aP＜0.05。

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表 3 2组Hp阳性慢性萎缩性胃炎患者治疗前后胃蛋白酶原表达情况比较(x±s)

Table 3. Comparison of pepsinogen expression before and after treatment in the two groups of HP-positive chronic atrophic gastritis patients(x±s)

组别	例数	PGⅠ(μg/L)		PGⅡ(μg/L)		PGⅠ/PGⅡ
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	45	65.66±9.49	72.11±8.56^a	14.88±5.08	13.42±3.39^a	4.55±1.07	5.27±1.71^a
观察组	45	65.79±8.98	78.43±8.98^a	14.39±4.65	11.55±2.87^a	4.69±1.06	6.13±1.21^a
t值		0.067	3.417	0.477	2.824	0.624	2.754
P值		0.947	0.001	0.643	0.006	0.535	0.007
注：与同组治疗前比较，^aP＜0.05。

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