【摘要】：目的:探究腸易激綜合征(irritable bowel syndrome,IBS)與幽門螺桿菌(helicobacter pylori,HP)感染情況之間的關(guān)聯(lián)性。方法:選取IBS患者共120例,健康體檢者共120例,通過14C尿素呼氣和快速尿素酶法檢測,分析腸易激綜合征與幽門螺桿菌感染情況之間的相關(guān)性;再者,按照IBS亞型,將HP陽性的IBS患者分為研究組與對(duì)照組,兩組同時(shí)給予匹維溴銨50mg,(便秘型IBS口服伊托必利50mg)每日3次,連續(xù)治療4周,同時(shí)研究組在此基礎(chǔ)上加用三聯(lián)療法(奧美拉唑20mg,克拉霉素0.5g加阿莫西林1g)治療HP感染,每日2次,持續(xù)2周,分別計(jì)算各亞型在研究組與對(duì)照組中的治療總有效率。結(jié)果:(1)幽門螺桿菌(HP)的感染率及其差異:120例腸易激綜合征(IBS)患者中有73人感染HP,感染率為60.8%;健康查體組的120例中有54人感染HP,感染率為45%,兩組之間有顯著性統(tǒng)計(jì)學(xué)差異(P0.01);(2)腸易激綜合征(IBS)各亞型間HP感染率及其比較:試驗(yàn)組120例患者中便秘型19例,HP感染率為47.3%(9/19);腹瀉型16例,HP感染率為75%(12/16);混合型16例,HP感染率為75%(12/16);未分化型69例,HP感染率為58%(40/69),腸易激綜合征(IBS)各亞型之間HP感染率的比較有統(tǒng)計(jì)學(xué)差異(P0.05);(3)HP陽性的腸易激綜合征(IBS)各亞型治療的總有效率為:腹瀉型治療總有效率(100%)顯著高于對(duì)照組(20%),兩者之間有顯著性統(tǒng)計(jì)學(xué)差異(P0.01);便秘型治療的總有效率(100%)高于相應(yīng)的對(duì)照組(0%),存在統(tǒng)計(jì)學(xué)差異(P0.05);混合型治療的總有效率(100%)高于對(duì)照組(16.7%),兩者的比較有統(tǒng)計(jì)學(xué)意義(P0.05);未定型治療的總有效率(75%)高于對(duì)照組(30%),有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)HP感染與腸易激綜合征存在相關(guān)性;(2)HP感染在腸易激綜合征各亞型之間有統(tǒng)計(jì)學(xué)的差異,兩者密切相關(guān);(3)幽門螺桿菌的治療是IBS各亞型的治療總有效率的決定因素之一。
[Abstract]:Objective: to investigate the relationship between (irritable bowel syndrome and helicobacter pylori infection. Methods: 120 patients with IBS and 120 healthy controls were selected to analyze the correlation between irritable bowel syndrome and Helicobacter pylori infection by 14C urea breath and rapid urease assay. Furthermore, according to the IBS subtype, Patients with HP positive IBS were divided into two groups: the study group and the control group. The patients in the two groups were given 50mg of piveronium bromide at the same time. The patients with constipated IBS were treated with itopride 50mg three times a day for 4 weeks. At the same time, the study group was treated with triple therapy (omeprazole 20 mg, clarithromycin 0.5 g and amoxicillin 1 g) for HP infection twice a day for 2 weeks. The total effective rates of each subtype in the study group and the control group were calculated. Results: (1) the infection rate of Helicobacter pylori (HP) and its difference were found in 73 out of 120 patients with irritable bowel syndrome (IBS) and 54 patients in the healthy check-up group (P < 0.05). There were significant statistics between the two groups. The infection rate of HP among the (IBS) subtypes of irritable bowel syndrome (P0.01); (2) and its comparison: the infection rate of constipation type was 47.3% (9 / 19), diarrhea type was 75% (12 / 16), mixed type was 75% (12 / 16), undifferentiated type 69%. The infection rate of HP was 58% (40 / 69) in patients with irritable bowel syndrome (IBS). There was significant difference in HP infection rate among the subtypes of irritable bowel syndrome (P0.05); (3). The total effective rate of HP positive (IBS) subtypes was: the total effective rate of diarrhea type treatment (100%) was significantly higher than that of the control group (100%). The total effective rate of constipation treatment (100%) was higher than that of the corresponding control group (0%) (P0.05), the total effective rate of mixed therapy (100%) was higher than that of the control group (16.7%), the total effective rate of constipation treatment (100%) was higher than that of the control group (16.7%). The total effective rate of unstereotyped treatment (75%) was significantly higher than that of the control group (30%) (P0.05). Conclusion: (1) HP infection is associated with irritable bowel syndrome (IBS), (2) HP infection is significantly different among the subtypes of IBS, and (3) the treatment of Helicobacter pylori is one of the determinants of the total effective rate of each subtype of IBS.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R574.4
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本文編號(hào)：2168788