目的 分析瑞巴派特联合三联疗法治疗老年消化性胃溃疡的临床效果。方法 回顾2014年6月-2015年10月到北海市中医医院诊治的消化性胃溃疡的老年患者共96例，按照随机原则分为两组，对照组48例患者采用雷贝拉唑、阿莫西林及克拉霉素三联疗法，观察组48例患者在此基础上加用瑞巴派特辅助治疗，比较两组患者疗效，观察两组患者治疗后1年复发情况，记录治疗后嗳气、反酸、腹痛及恶心等临床症状缓解时间，检测治疗前后胃黏膜前列腺素E2（PGE2）水平、转化生长因子β1（TGF-β1）、白介素-17（IL-17）及白介素-25（IL-25）等炎症因子水平，观察治疗期间口干、腹胀、便秘及皮肤瘙痒等不良反应发生情况。结果 观察组患者治疗总有效率达97.92%，显著高于对照组患者的81.25%（P<0.05）；治疗后1年观察组患者复发率仅8.33%，显著低于对照组患者的31.25%（P<0.05）；治疗后嗳气、反酸、腹痛及恶心等临床症状缓解时间均显著短于对照组患者（P<0.05）。两组患者治疗前黏膜厚度、腺体密度、活动性炎症细胞浸润及慢性炎症细胞浸润等胃黏膜形态学评分未表现出明显差异；治疗后两组以上指标均较治疗前明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组患者降低幅度均明显大于对照组患者，差异具有统计学意义（P<0.05）。两组患者治疗前胃黏膜PGE2、TGF-β1、IL-17及IL-25等炎症因子水平未表现出明显差异；治疗后两组以上指标均较治疗前明显改善，同组治疗前后比较差异有统计学意义（P<0.05）；观察组患者治疗后胃黏膜PGE2水平明显高于对照组患者，TGF-β1、IL-17及IL-25等炎症因子水平均明显低于对照组患者，差异具有统计学意义（P<0.05）。两组患者治疗期间口干、腹胀、便秘及皮肤瘙痒等不良反应发生率未表现出明显差异。结论 瑞巴派特联合三联疗法治疗老年消化性胃溃疡临床疗效确切，能够有效改善胃黏膜形态学，降低复发率，建议临床推广应用。

Objective To analyze the clinical efficacy of rebamipide adjuvant therapy for elderly peptic gastric ulcer.Methods 96 elderly patients diagnosed with peptic gastric ulcer in our hospital from June 2014 to October 2015 were involved in this research.They were randomly divided into two groups.48 patients in control group were treated with triple therapy of rabeprazole,amoxicillin and clarithromycin,and 48 patients in observation group were treated with rebamipide based on the therapy of control group.Efficacy was compared in two groups.Results Total effective rate in observation group was significantly higher than that in control group,recurrence rate at 1 year was obviously lower compared to control group,and remission time of belching,acid reflux,stomachache and nausea after treatment were significantly shorter than those in control group (P<0.05).After treatment,scores of mucous membrane thickness,glandular density,active inflammatory cell infiltration and chronic inflammatory cell infiltration in observation group were significantly lower than those in control group,level of gastric mucosa PGE2 was obviously higher compared to control group,and levels of TGF-β1,IL-17 and IL-25 were significantly lower than those in control group (P<0.05).Adverse reaction incidences of dry mouth,abdominal distension,constipation and skin itching in two groups during treatment showed no significant difference.Conclusion Rebamipide adjuvant therapy is effective for elderly peptic gastric ulcer,which can improve gastric mucosa morphology and reduce recurrence rate,and recommend clinical popularization and application.