目的 探讨艾普拉唑序贯疗法对消化性溃疡患者治疗效果及血清学指标的影响。方法 选取2015年10月—2019年4月河南省人民医院省直二院584例消化性溃疡患者作为研究对象，根据治疗方法的不同将患者分为对照组（n=193）和观察组（n=391）。对照组口服奥美拉唑肠溶胶囊，20 mg/次，1次/d；克拉霉素胶囊，0.5 g/次，1次/d；呋喃唑酮片，0.1 g/次， 1次/d。观察组口服艾普拉唑肠溶片，5 mg/次，2次/d；克拉霉素胶囊0.5 g/次，1次/d；连续治疗5 d后再次口服艾普拉唑肠溶片，5 mg/次，2次/d；呋喃唑酮片0.1 g/次，1次/d。两组患者均连续治疗10 d。观察两组患者的临床疗效和幽门螺旋杆菌（Hp）阳性率，同时比较两组治疗前后的血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）、一氧化氮（NO）、白细胞介素-17（IL-17）和胃泌素（Gas）水平。结果 治疗后，观察组治疗总有效率为95.91%，显著高于对照组的80.31%（P<0.05）。治疗后，两组的VEGF、bFGF水平明显升高，NO及IL-17水平明显降低（P<0.05），且观察组各指标改善较对照组更为显著（P<0.05）。治疗后，两组的Gas水平及Hp阳性率均明显降低（P<0.05），且观察组Gas水平和Hp阳性率均显著低于对照组（P<0.05）。结论 艾普拉唑序贯疗法可有效清除Hp，降低血清胃泌素水平及局部炎性反应，疗效安全显著，对促进消化性溃疡患者病情康复具有积极意义。

Objective To investigate the effect of ilaprazole sequential therapy on treatment effect and serological index of peptic ulcer patients. Methods A total of 584 patients with peptic ulcer in the The Second Hospital of Henan Provincial People's Hospital from October 2015 to April 2019 were selected as research objects and divided into control group (n=193) and observation group (n=391) according to different treatment methods. Patients in the control group were po administered with Omeprazole Enteric-Coated Capsules, 20 mg/time, once daily; Clarithromycin Capsules, 0.5 g/time, once daily; and Furazolidone Tablets 0.1 g/time, once daily. Patients in the observation group were po administered with Ilaprazole Enteric-coated Tablets, 5 mg/time, twice daily; Clarithromycin Capsules, 0.5 g/time, once daily. After continuous treatment for 5 days, Ilaprazole Enteric-coated Tablets were taken orally again, 5 mg/time, twice daily, and Furazolidone Tablets 0.1 g/time for once daily. Both groups received continuous treatment for 10 days. After treatment, the clinical efficacy and Helicobacter pylori positive rate in two groups were observed, and the levels of VEGF, bFGF, NO, IL-17, and Gas before and after treatment were compared. Results After treatment, the total effective rate of the observation group was 95.91%, which was significantly higher than 80.31% of the control group (P<0.05). After treatment, the levels of VEGF and bFGF in two groups were significantly increased, while the levels of NO and IL-17 were significantly decreased (P<0.05), and the improvement of indicators in the observation group was more significant than those in the control group (P<0.05). After treatment, Gas level and Hp positive rate in both groups were significantly reduced (P<0.05), and Gas level and Hp positive rate in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Ilaprazole sequential therapy can effectively remove Hp, reduce serum gastrin level, and local inflammatory reaction, with safe and significant efficacy, and has positive significance in promoting the recovery of patients with peptic ulcer.

R975

河南省医学科技攻关计划项目（201302012）