Observation on the curative effect of plasma ablation combined with quadruple therapy in the treatment of Hp positive verrucous gastritis under gastroscope
Objective To analyze the application value of endoscopic plasma ablation combined with quadruple therapy in the treatment of Helicobacter pylori(Hp)positive verrucous gastritis(VG).Methods A total of 78 Hp positive VG patients in Yucheng County People's Hospital from 2020-02-06 to 2022-04-07 were selected and divided into two groups by computer random method,with 39 cases in each group.The conventional group was treated with quadruple therapy,es-omeprazole orally,0.02 g/time,2 times/d;Oral clarithromycin dispersible tablet,0.5 g/time,2 times/d;Oral amoxi-cillin capsules,0.5 g/time,3 times/day;Bismuth potassium citrate granules,0.22 g/time,2 times/day.The operation group was given quadruple therapy after endoscopic plasma ablation,and the control group was given quadruple therapy for 4 weeks.The efficacy,Hp clearance rate and adverse reactions of the two groups were observed,The symptom scores,inflammatory mediators[transforming growth factor β(TGF-β),C-reactive protein(CRP),procalcitonin(PCT)],gastric mucosal function[gastrin(GAS),somatostatin(SS),pepsinogen Ⅰ(PG Ⅰ)]were compared before and after treatment.The count data were represented by n(％),x2test was conducted,and the measurement data were represented by((x)±s),and t test was used.Results The total effective rate and Hp clearance rate in the operation group were 97.44％(38/39)and 94.87％(37/39),which were significantly higher than 79.49％(31/39)and 76.92％(30/39)in the conventional group(x2=4.552,5.186,all P＜0.05).After treatment,the scores of abdominal fullness,gastric acid reflux and abdominal pain in the operation group were(1.08±0.41)points,(1.14±0.34)points and(0.95±0.31)points,respectively.The scores were significantly lower than those in the conventional group[(1.94± 0.39)points,(2.08±0.38)points,(1.73±0.35)points](F=7.175,8.127,7.589,all P＜0.001).After treatment,the levels of TGF-β,CRP,PCT and PGI in the operation group were(13.38±3.55)mg/ml,(5.49±2.76)mg/l,(0.92± 0.31)mg/ml,and(33.48±4.66)μg/l,respectively,which were lower than(16.72±4.27)mg/ml,(9.58± 3.14)mg/l,(1.48±0.44)mg/ml,and(41.75±5.03)μg/l in the conventional group;The levels of SS and GAS were(15.27±2.94)pg/ml and(22.43±3.55)pg/ml,respectively.They were higher than those in the conventional group[(13.89±2.53)pg/ml,(18.15±3.52)pg/ml](F=10.574,12.498,6.732,18.822,7.428,11.536,all P＜0.001).There was no significant difference in the total incidence of adverse reactions between the surgery group(7.69％,3/39)and the conventional group(5.13％,2/39)(x2=0.000,P=1.000).Conclusions Gastroscopic plasma ablation com-bined with quadruple therapy can improve the Hp clearance rate of Hp positive VG patients and reduce inflammatory re-action.It is helpful to improve the function of gastric mucosa,relieve the symptoms of patients,enhance the curative effect,and has high safety.
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