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目的研究舍曲林治疗幽门螺杆菌(Hp)阳性消化性溃疡合并抑郁症的疗效。方法 166例Hp阳性消化性溃疡合并抑郁症患者被随机分为治疗组86例和对照组80例。2组均给予相同的三联疗法治疗Hp阳性消化性溃疡,治疗组采用舍曲林治疗抑郁症,对照组采用阿米替林治疗抑郁症。观察2组的腹痛程度、电子胃镜检查结果、Hp清除率、HAMD评分结果和药物不良反应。结果 166株Hp菌株对甲硝唑的耐药率较高,为75.9%;而对阿莫西林、左氧氟沙星、呋喃唑酮、克拉霉素的耐药率较低。治疗8周后,2组的腹痛程度均比治疗前显著下降且治疗组的腹痛程度比对照组低,差异均有统计学意义(P<0.05);2组的HAMD评分结果分别为(12.4±3.6)分和(19.0±3.9)分,均比治疗前显著下降且治疗后治疗组的HAMD评分结果比对照组低,差异均有统计学意义(P<0.05);治疗组的显效率为55.8%,总有效率为89.5%;治疗组的显效率和总有效率均显著高于对照组(χ~2=10.597、6.019,均P<0.05)。治疗组的Hp清除率为93.0%(80/86),对照组的Hp清除率为78.8%(63/80),治疗组的Hp清除率比对照组高,差异有统计学意义(P<0.05)。2组不良反应发生率,差异无统计学意义(χ~2=1.457,P>0.05)。结论舍曲林联合三联疗法可治疗Hp阳性消化性溃疡合并抑郁症,且不良反应较少,具有较高的临床推广价值。
Objective To study the efficacy of sertraline in the treatment of Helicobacter pylori (Hp) -positive peptic ulcer with depression. Methods A total of 166 patients with Hp-positive peptic ulcer complicated by depression were randomly divided into treatment group (n = 86) and control group (n = 80). Both groups were given the same triple therapy for Hp-positive peptic ulcer, sertraline treatment of depression in the treatment group, and amitriptyline treatment of depression in the control group. The degree of abdominal pain, electronic gastroscopy, Hp clearance, HAMD score and adverse drug reactions were observed in the two groups. Results The resistance rate of 166 Hp strains to metronidazole was high, which was 75.9%. However, the resistance rate to amoxicillin, levofloxacin, furazolidone and clarithromycin was low. After 8 weeks of treatment, the degree of abdominal pain in both groups decreased significantly and the degree of abdominal pain in the treatment group was lower than that in the control group (P <0.05). The HAMD scores of the two groups were (12.4 ± 3.6) and (19.0 ± 3.9) points respectively, which were significantly lower than those before treatment. The HAMD score of the treatment group after treatment was lower than that of the control group (P <0.05), and the effective rate of the treatment group was 55.8 %, The total effective rate was 89.5%. The effective rate and total effective rate of the treatment group were significantly higher than those of the control group (χ ~ 2 = 10.597,6.019, all P <0.05). The Hp clearance rate of the treatment group was 93.0% (80/86), the Hp clearance rate of the control group was 78.8% (63/80), and the Hp clearance rate of the treatment group was higher than that of the control group (P <0.05 ). There was no significant difference in adverse reaction between the two groups (χ ~ 2 = 1.457, P> 0.05). Conclusion Combined sertraline and triple therapy can treat Hp-positive peptic ulcer with depression, with fewer adverse reactions and higher clinical value.