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目的探讨原发性胆汁反流性胃炎采用熊去氧胆酸联合治疗的临床疗效。方法 84例原发性胆汁反流性胃炎患者,按照数字表法随机分成对照组和治疗组,每组42例。对照组患者采用铝碳酸镁和莫沙必利进行治疗,治疗组患者在对照组治疗基础上联合熊去氧胆酸进行治疗,8周为1个疗程。对两组患者治疗后的症状缓解率、症状积分(腹胀、腹痛和呕吐)、不良反应发生率和复发率进行比较。结果对照组患者的症状缓解率为76.2%、治疗组患者的症状缓解率为95.2%,治疗组症状缓解率高于对照组,差异具有统计学意义(P<0.05);治疗组患者治疗后腹胀、腹痛和呕吐症状积分分别为(0.53±0.26)、(0.79±0.45)、(0.23±0.11)分,对照组患者治疗后腹胀、腹痛和呕吐症状积分分别为(0.94±0.43)、(1.21±0.52)、(0.68±0.14)分,两组治疗后各症状积分均优于治疗前,差异具有统计学意义(P<0.05);治疗后治疗组各项积分优于对照组,差异具有统计学意义(P<0.05);对照组患者治疗后不良反应发生率为23.8%,治疗组患者治疗后不良反应发生率为7.1%,治疗组不良反应发生率少于对照组,差异具有统计学意义(P<0.05);对照组患者复发率为19.0%,治疗组患者复发率为4.8%,治疗组复发率明显低于对照组,差异具有统计学意义(P<0.05)。结论原发性胆汁反流性胃炎在铝碳酸镁和莫沙必利治疗基础上联合使用熊去氧胆酸治疗,能够显著的提高治疗的效果、快速的缓解临床症状、减少并发症的发生和降低复发率,值得在临床中广泛的推广应用。
Objective To investigate the clinical efficacy of ursodeoxycholic acid combined with primary bile reflux gastritis. Methods Eighty-four patients with primary bile reflux gastritis were randomly divided into control group and treatment group according to digital table method, with 42 cases in each group. Patients in the control group were treated with aluminum magnesium carbonate and mosapride. The patients in the treatment group were treated with ursodeoxycholic acid on the basis of the control group, and the course of treatment was 8 weeks. Symptom remission rate, symptom score (bloating, abdominal pain and vomiting), incidence of adverse reactions and recurrence were compared between the two groups after treatment. Results The symptom relief rate was 76.2% in the control group and 95.2% in the treatment group, and the symptom relief rate in the treatment group was higher than that in the control group (P <0.05). The bloated after treatment in the treatment group (0.53 ± 0.26), (0.79 ± 0.45) and (0.23 ± 0.11) points respectively in the control group were (0.94 ± 0.43) and (1.21 ±) respectively after treatment, the score of abdominal pain and vomiting were (0.53 ± 0.26) and 0.52) and (0.68 ± 0.14) points respectively. After treatment, the scores of each symptom were better than those before treatment (P <0.05), and the scores of the treatment group were better than those of the control group (P0.05). The incidence of adverse reactions in the control group was 23.8% after treatment, the incidence of adverse reactions in the treatment group was 7.1% after treatment, and the incidence of adverse reactions in the treatment group was less than that in the control group (P <0.05) P <0.05). The recurrence rate was 19.0% in the control group and 4.8% in the treatment group, and the recurrence rate in the treatment group was significantly lower than that in the control group (P <0.05). Conclusions Primary bile-reflux gastritis combined with ursodeoxycholic acid treatment based on the treatment of aluminum magnesium carbonate and mosapride can significantly improve the therapeutic effect, quickly relieve the clinical symptoms and reduce the incidence of complications Reduce the recurrence rate, it is worth widely in clinical application.