目的 探讨含阿莫西林克拉维酸钾的铋剂四联方案治疗幽门螺杆菌感染致慢性胃炎的临床疗效。方法 选取2020年5月—2021年8月在北京市海淀医院消化内科接受治疗的116例幽门螺杆菌感染致慢性胃炎患者为研究对象，按照治疗方案不同将患者分为对照组和试验组，每组58例，对照组给予含阿莫西林的铋剂四联方案治疗，试验组给予含阿莫西林克拉维酸钾的铋剂四联方案治疗，两组均治疗14 d。分别于治疗前后采用酶联免疫吸附（ELISA）法检测血清炎症因子白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、胃动素（MTL）、胃泌素（GAS）水平；分别于治疗前后采用流式细胞仪检测T淋巴细胞亚群（CD4⁺、CD8⁺、CD4⁺/CD8⁺）水平的变化；记录两组治疗总有效率和不良反应发生率。结果 治疗后，对照组和试验组患者血清IL-6、TNF-α、CRP、GAS、CD8⁺水平较本组治疗前均显著降低（P＜0.05），而MTL、CD4⁺、CD4⁺/CD8⁺水平较本组治疗前均显著升高（P＜0.05），且治疗后试验组血清IL-6、TNF-α、CRP、GAS、CD8⁺水平显著低于对照组（P＜0.05），MTL、CD4⁺、CD4⁺/CD8⁺水平显著高于对照组（P＜0.05）。试验组的总有效率为93.10%，显著高于对照组的79.31%（P＜0.05），试验组的不良反应发生率为6.90%，显著低于对照组的12.07%（P＜0.05）。结论 含阿莫西林克拉维酸钾的铋剂四联方案治疗幽门螺杆菌感染致慢性胃炎疗效更为显著，能抑制机体内炎症反应、调控胃肠道激素分泌，提高患者免疫力，多途径共同作用促进患者病情好转，值得临床推广使用。

Objective To explore the clinical efficacy of bismuth quadrupl therapy containing amoxicillin/potassium clavulanate in treatment of chronic gastritis induced by Helicobacter pylori infection. Methods A total of 116 patients with Helicobacter pylori infection-related gastritis who were treated in the Department of Gastroenterology of Beijing Haidian Hospital from May 2020 to August 2021 were selected. According to the different treatment schemes, the patients were divided into control group and experimental group, with 58 cases in each group. Patients in control group were treated with bismuth quadrupl therapy containing amoxicillin, and patients in experimental group were treated with bismuth quadrupl therapy containing amoxicillin/potassium clavulanate. Both patients were treated for 14 days. Serum inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP), motilin (MTL), gastrin (GAS) levels were detected by enzyme-linked immunosorbent assay (ELISA) before and after treatment. The changes of T lymphocyte subsets (CD4⁺, CD8⁺, CD4⁺/CD8⁺) were detected by flow cytometry before and after treatment. The total effective rate and adverse reaction rate of two groups were recorded. Results After treatment, serum IL-6, TNF-α, CRP, GAS, CD8⁺ levels in control group and experimental group were significantly lower than those before treatment (P < 0.05), while MTL, CD4⁺, CD4⁺/CD8⁺ levels were significantly higher than those before treatment (P < 0.05). Serum IL-6, TNF-α, CRP, GAS, CD8⁺ levels in experimental group after treatment were significantly lower than those in control group (P < 0.05), while MTL, CD4⁺, CD4⁺/CD8⁺ levels were significantly higher than those in control group (P < 0.05). The total effective rate of the experimental group was 93.10%, significantly higher than 79.31% of the control group (P < 0.05), and the incidence of adverse reactions in the experimental group was 6.90%, significantly lower than 12.07% of the control group (P < 0.05). Conclusion The bismuth quadrupl therapy containing amoxicillin/potassium clavulanate is more effective in treatment of chronic gastritis caused by Helicobacter pylori infection. It can inhibit the inflammatory reaction in body, regulate the secretion of gastrointestinal hormones, improve the immunity of patients, and promote the improvement of patients' conditions through multiple ways, which is worthy of clinical promotion.

R975