目的 研究含铋剂四联疗法对胃十二指肠溃疡患者疼痛症状、胃幽门螺杆菌的影响。方法 选取顺义区空港医院内科2014年9月-2016年12月收治的120例以疼痛为主要症状的胃十二指肠溃疡患者作为研究对象。根据随机数表法分为对照组60例，于早晚餐后30 min接受口服埃索美拉唑镁肠溶片，早晚餐后30 min口服阿莫西林胶囊、克拉霉素缓释片方案治疗；研究组60例，在对照组三联疗法基础上加服枸橼酸铋钾胶囊早晚餐前30 min口服。治疗2周后继续服用4~6周的质子泵抑制剂、胃黏膜保护剂，观察两组患者疼痛缓解时间、胃幽门螺杆菌根除率，并比较症状缓解效果、药物不良反应发生率。结果 研究组患者上腹疼痛缓解时间低于对照组，差异有统计学意义（P<0.05）。治疗后研究组患者幽门螺杆菌根除率（91.7%）明显高于对照组（76.7%），差异有统计学意义（P<0.05）。研究组患者症状缓解总有效率、不良反应发生率与对照组比较，差异无统计学意义。结论 采用含铋剂四联疗法治疗胃十二指肠溃疡效果显著，安全性高，能减轻患者上腹疼痛症状，提高胃幽门螺杆菌根除效果，促进溃疡愈合，值得临床推广应用。

Objective To study the influence of bismuth based quadruple therapy on painful symptoms and helicobacter pylori in patients with gastroduodenal ulcer. Methods 120 gastroduodenal ulcer patients with pain as the main syndrome in the internal medicine of Shunyi district Konggang hospital from September 2014 to December 2016 were selected as research object. According to random number table, they were divided intro control group (n=60) which orally took esomeprazole magnesium enteric-coated tablets before meal for 30min, and took amoxicillin capsules, clarithromycin sustained-release tablets after meal for 30 min. Research group (n=60) was given bismuth potassium citrate capsules before meal for 30 min based on control group. After two-week treatment, patients continued to take proton-pump inhibitor and gastric mucosal protective agents for 4 to 6 weeks. The pain alleviation time, eradication rate of helicobacter pylori of two groups were observed. The symptom alleviation effects and the incidence of drug adverse reactions were compared between the two groups. Results The epigastric pain alleviation time in research group was lower than that in control group (P < 0.05). After the treatment, the eradication rate of helicobacter pylori in research group (91.7%) was significantly higher than that in control group (76.7%) (P < 0.05). The total effective rate of symptom alleviation, the incidence of adverse reactions were compared between the two groups, and there was no statistical difference. Conclusion Bismuth based quadruple therapy for gastroduodenal ulcer is effective and has high safety, it can reduce the epigastric pain of patients, increase eradication of helicobacter pylori, promote healing of ulcer, which is worthy of clinical promotion and application.