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目的总结根除幽门螺杆菌(Hp)对Hp阳性的功能性消化不良(FD)患者的治疗作用与价值。方法将入选患者随机分为两组:对照组78例,给予奥美拉唑治疗1周;治疗组82例,给予奥美拉唑、阿莫西林、克拉霉素、胶体果胶铋等治疗1周。停药1月时对治疗组患者做14C-尿素呼气试验,根据结果将其再分为根除Hp组和根除Hp失败组。对每组患者治疗前和治疗后1月时的平均症状积分、平均治疗得分进行比较。随访12个月,比较随访期每组患者消化不良症状发生的平均天数及因本病就诊的平均医疗费用等。结果每组患者治疗前与治疗后1月时平均症状积分比较,均有显著差异(P<0.05):根除Hp组平均治疗得分2.77分,对照组1.01分;根除Hp失败组分0.98分;根除Hp组与其他两组比较,均有显著差异(P<0.05)。根除Hp组随访期平均症状发生天数26.41 d,对照组50.84d,根除Hp失败组52.20 d。根除Hp组随访期平均医疗费用1 575.16元,根除Hp失败组2 992.44元,对照组2 841.37元。根除Hp组与其他两组比较差异均有统计学意义(P<0.05)。结论根除Hp治疗对Hp阳性的FD能够明显提高治疗效果,降低医疗费用。
Objective To summarize the therapeutic effect and value of eradication of Helicobacter pylori (Hp) on Hp-positive patients with functional dyspepsia (FD). Methods The selected patients were randomly divided into two groups: control group 78 cases, given omeprazole treatment for 1 week; treatment group 82 cases, given omeprazole, amoxicillin, clarithromycin, colloidal bismuth pectin and other treatment 1 week. At the end of January, 14 C-urea breath tests were performed on patients in the treatment group, which were subdivided into Hp-eradicated group and Hp-eradicated group according to the results. The mean symptom scores and mean treatment scores of each group before treatment and at 1 month after treatment were compared. The patients were followed up for 12 months. The mean days of dyspeptic symptoms and the average medical expenses for this disease were compared between follow-up periods. Results The average symptom scores of each group before treatment and 1 month after treatment were significantly different (P <0.05): the average treatment score of Hp group was 2.77 points, the control group was 1.01 points; the Hp failure group of 0.98 points was eradicated; Hp group compared with the other two groups, there was a significant difference (P <0.05). The mean symptom onset time was 26.41 days in the Hp group, 50.84 days in the control group and 52.20 days in the Hp failure group. The average medical expenses for eradication of Hp group during the follow-up period were 1575.16 yuan, 2 992.44 yuan for eradication of Hp failure group and 2 841.37 yuan for control group. Eradication of Hp group compared with the other two groups were statistically significant (P <0.05). Conclusion Hp-positive Hp-eradication therapy can significantly improve the therapeutic effect and reduce the medical costs.