2021 年第 5 期 第 16 卷

雷贝拉唑联合法莫替丁治疗十二指肠溃疡的效果及对患者氧化应激指标水平的影响

Curative effect of rabeprazole combined with famotidine on patients with duodenal ulcer and its influence on oxidative stress index levels

作者：李明1朱飞1殷继鹏2耿雪峰3江梅1

英文作者：Li Ming1 Zhu Fei1 Yin Jipeng2 Geng Xuefeng3 Jiang Mei1

单位：1西安市第四医院消化内科710004；2空军军医大学西京消化病医院消化内科，西安710032；3西安市蓝田县张家坪医院消化内科710507

英文单位：1Department of Gastroenterology Xi′an Fourth Hospital Xi′an 710004 China; 2Department of Gastroenterology Xijing Digestive Disease Hospital Air Force Medical University Xi′an 710032 China; 3Department of Gastroenterology Zhangjiaping Hospital Lantian County Xi′an 710507 China

关键词：十二指肠溃疡；雷贝拉唑；法莫替丁；氧化应激反应

英文关键词：Duodenalulcer;Rabeprazole;Famotidine;Oxidativestressresponse

• 摘要：

• 目的 探讨雷贝拉唑联合法莫替丁用于十二指肠溃疡患者的疗效及对氧化应激指标水平的影响。方法 选取2018年4月至2019年11月西安市第四医院、空军军医大学西京消化病医院和西安市蓝田县张家坪医院收治的134例十二指肠溃疡患者，按随机数字表法分为雷贝拉唑组和联合用药组，每组67例。雷贝拉唑组在常规干预基础上使用雷贝拉唑肠溶片口服治疗；联合用药组在雷贝拉唑组基础上加用法莫替丁口服治疗；治疗周期为6周，幽门螺杆菌（Hp）根除治疗方法 为雷贝拉唑、胶体酒石酸铋胶囊、阿莫西林、克拉霉素四联口服治疗。观察2组患者治疗前后的胃肠道症状评分、溃疡面积及愈合情况、治疗效果、Hp根除情况、氧化应激反应及不良反应发生情况。结果 治疗后联合用药组胃肠道症状评分低于雷贝拉唑组、溃疡面积小于雷贝拉唑组、溃疡愈合率高于雷贝拉唑组（均P＜0.05）。联合用药组总有效率、Hp根除率高于雷贝拉唑组［94.0%（63/67）比82.1%（55/67）、95.5%（64/67）比77.6%（52/67）］，差异均有统计学意义（均P＜0.05）。治疗后联合用药组超氧化物歧化酶、谷胱甘肽过氧化物酶水平高于雷贝拉唑组，丙二醛水平低于雷贝拉唑组［（120±39）kU/L比（101±28）kU/L、（141±46）μg/L比（116±34）μg/L、（4.6±1.5）mmol/L比（5.4±1.8）mmol/L］，差异均有统计学意义（均P＜0.05）。2组不良反应发生率差异无统计学意义（P>0.05）。结论 雷贝拉唑联合法莫替丁可有效缓解十二指肠溃疡患者临床症状，提高治疗总有效率，有效降低患者丙二醛水平，上调超氧化物歧化酶、谷胱甘肽过氧化物酶水平，减轻机体氧化应激反应。

• Objective To explore the curative effect of rabeprazole combined with famotidine on patients with duodenal ulcer and its influence on oxidative stress index levels. Methods From April 2018 to November 2019, 134 patients with duodenal ulcer in Xi′an Fourth Hospital, Xijing Digestive Disease Hospital, Air Force Medical University, and Zhangjiaping Hospital, Lantian County, Xi′an were selected. They were randomly divided into rabeprazole group and combined medication group, with 67 cases in each group. Rabeprazole group was treated with rabeprazole enteric-coated tablets on the basis of routine intervention; combined medication group was treated with famotidine on the basis of rabeprazole group; the treatment cycle was 6 weeks, and Helicobacter pylori(Hp) eradication therapy was combined with rabeprazole, colloidal bismuth tartrate capsules, amoxicillin and clarithromycin. The gastrointestinal symptom score, ulcer area and healing, treatment effect, Hp eradication, oxidative stress response and adverse reactions in the two groups were observed. Results After treatment, the gastrointestinal symptom score and ulcer area of the combined medication group were lower/less than those of the rabeprazole group, and ulcer healing rate of the combined medication group was higher than that of the rabeprazole group(all P<0.05). The total effective rate and Hp eradication rate of the combined medication group were higher than those of the rabeprazole group［94.0%(63/67) vs 82.1%(55/67), 95.5%(64/67) vs 77.6%(52/67)］(both P<0.05). After treatment, the levels of superoxide dismutase and glutathione peroxidase of the combined medication group were higher than those of the rabeprazole group, and the level of malondialdehyde of the combined medicationgroup was lower than those of the rabeprazole group［(120±39)kU/L vs (101±28)kU/L, (141±46)μg/L vs (116±34)μg/L, (4.6±1.5)mmol/L vs (5.4±1.8)mmol/L］(all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Rabeprazole combined with famotidine can effectively relieve the clinical symptoms of patients with duodenal ulcer, improve the total effective rate of treatment, and effectively reduce malondialdehyde level, up-regulate the levels of superoxide dismutase and glutathione peroxidase, and reduce the body′s oxidative stress response.