| Effect a radical cure of helicobacter pylori(H.pylori)infection are all experts and scholars at home and abroad in recent years,the emphasis and difficulty in facing in clinical research work.The current study found that H.pylori infection is the cause of the world in the field of chronic gastritis is the most common,and may develop gastrointestinal ulcer and gastric adenocarcinoma.The infection rate of H.pylori in the natural population in the world is more than 50%,and the infection rate of the elderly over the age of 60 is as high as 70%,Newly released H.pylori Kyoto global consensus and Maastricht V consensus recommendations in order to prevent the occurrence of gastric cancer,should eradicate H.pylori.The eradication of the current domestic and international H.pylori plan more,but in the true sense of the eradication rate high,high remission rate and less adverse reaction and good compliance and eradication and relatively inexpensive solutions are rare.More and more reports pointed out:because of the side effects of drugs,cause the failure of H.pylori eradication in the elderly,further development of a series of diseases associated with H.pylori infection.Therefore,it is necessary to explore a new effective radical cure method.Objective:Through clinical observation the eradication of helicobacter pylori H.pylori in elderly patients,Assessment to evaluate the efficacy of small dose antibiotics combined with compound glutamine granules in the eradication of H.pylori infection in elderly patients,and the solution in the symptom remission rate,incidence of adverse reactions,patients’ compliance,cost and other aspects such as the difference between the treatment.Methods:According to the inclusion and exclusion criteria,selection on February1,2015 to December 31,2016 for acid reflux,heartburn,epigastric pain,the symptom such as full bilge in chengde city,hebei province center hospital patients with digestive internal medicine outpatient clinic or hospital treatment,electronic gastroscopy results suggest peptic ulcer,further underwent rapid urease test(RUT)and 13C-urea breath test(13C-UBT)confirmed H.pylori infection the initial treatment of elderly patients with a total of 272 cases,the treatment of each patient card mantissa according to the random number table method were divided into different treatment groups:A:rabeprazole azole10 mg daily 2 times+colloidal bismuth pectin 300 mg daily 2 times+amoxicillin1.0g daily 2 times +clarithromycin 500 mg daily 2 times,period of treatment,a total of 10 days;B:rabeprazole azole 10 mg daily 2 times+colloidal bismuth pectin 300 mg daily 2 times+amoxicillin 0.5g daily 3 times +clarithromycin250mg daily 3 times,period of treatment,a total of 10 days;C:rabeprazole azole 10 mg daily 2 times+compound glutamine granules 0.67 g daily 3times+amoxicillin 1.0g daily 2 times +clarithromycin 500 mg daily 2 times,period of treatment,a total of 10 days;D:rabeprazole azole 10 mg daily 2times+compound glutamine granules 0.67 g daily 3 times+amoxicillin 0.5g daily 3 times +clarithromycin 250 mg daily 3 times,period of treatment,a total of 10 days.After the eradication of H.pylori treatment continue to oral rabeprazole azole 4 weeks treatment peptic ulcer,then stop using bismuth agent and the above two kinds of antibiotics for at least 4 weeks,rabeprazole azole for at least 2 weeks,to evaluate the difference of eradication rate,clinical symptom remission rate and cost of H.pylori,and through the way of telephone follow-up record each patient occurrence of adverse reactions and compliance.In order to find a more reasonable,economical and safe method for eradicating H.pylori infection in the elderly.Results:1 Comparison of eradication rates of H.pylori in different schemes A,B,C,D four groups of H.eradication rate according to the intention to treat analysis were 87.7%(57/65),81.7%(58/71),89.4%(59/66),and 84.3%(59/70),the difference was not statistically significant(P>0.05);According to the treatment plan analysis were 89.1%(57/64),86.6%(58/67),92.2%(59/64),89.4%(59/66),the difference was not statistically significant(P>0.05).2 Comparison of symptom relief rate in different schemes The total effective rate of A group was 85.9%(55/64),the total effective rate of B group was(58/67),the total effective rate of C group was 92.2%(59/64),and the total effective rate was D(61/66).The total effective rate of C group and D two group was higher than that of A and B two groups,but the difference was not statistically significant(P>0.05).3 Comparison of adverse reactions in patients with different regimens The adverse reactions of the four groups of solutions to dry mouth,mouth pain,nausea,constipation,dry stool,stool color black and other symptoms,and were well tolerated,no serious adverse reactions.The incidence of adverse reactions in the four groups were 34.4%(22/64),17.9%(12/67),14.1%(9/64),3%(2/66),and the difference was statistically significant(P<0.05).The four groups were compared with each other: A,B two groups,A,C two groups,A,D two group,B,D two group and C,D two group,the difference was statistically significant(P<0.05);Compared with B,C two groups,the difference was not statistically significant(P>0.05).A group had the highest incidence of adverse reactions,D group had the lowest incidence of adverse reactions.4 Cost effectiveness analysis Cost of four groups were 377.35 yuan,351.79 yuan and 299.61 yuan,351.79 yuan.The cost-effectiveness ratio of the four groups were 4.24,4.06,3.25,and 3.06,respectively.Conclusion:Small doses of antibiotics combined compound glutamine granules quadruple therapy for the elderly H.pylori infection for H.pylori eradication rate is higher,higher remission rate,adverse reactions to a minimum,lowest cost,is a kind of more reasonable,economic and security of new scheme,is worth popularizing in clinical use. |
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