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目的:研究湘潭制槟榔与幽门螺旋杆菌感染相关关系. 方法:首先随机对1914例工矿、城市人口进行流行学调查,了解嚼槟榔与上消化道症状的分布情况.之后,从上述1914例中随机抽取105例无临床症状的人群分成食槟榔组55例,不食组50例,做血清抗H pylori-IgG检查; 另外,在内镜室对1814例有消化道症状的患者随机分成嚼湘潭制槟榔实验组956例和不嚼者的对照组858例.然后, 通过胃镜对每位患者进行镜下胃窦部取2-3块标本做尿素酶检测,并进行实验室体外H pylori抑菌试验.在临床上快速尿素酶、病理切片、涂片方法找H pylori,其中上述三项中两项为阳性者为H pylori阳性,共60例,分成治疗组及对照组各30例,治疗组用湘潭制槟榔每日8-50 g, 对照组用传统三联(铋剂+氨苄青霉素+甲硝唑),治疗2 wk,停药后1mo复查14C呼气试验. 结果:流行学调查,1914例中嚼槟榔1236例,有上消化道症状的383例(占30.99%),且有上消化道症状的人中有嚼槟榔后缓解的153例(占39.34%),而不嚼槟榔者678 例,有上消化道症状的215例(占31.71%);血清学调查,嚼槟榔组55例中,抗H pylori-IgG阴性者43例(占78.18%)、阳性12例(占21.82%),不嚼食50例抗H pylori-IgG阴性者22例(占44%),阳性28例(占56%).另外,内镜调查, 两组1814例中,实验组H pylori阳性率26.46%,对照组71.95%(P<0.005).体外小剂量湘潭制槟榔对幽门螺旋杆菌有明显的杀灭作用.临床60例H pylori感染患者中,治疗组30例,其中17例H pylori阴性(占56.67%),对照组30例中H pylori阴性21例(占70%),两组对此无明显差异(P>0.05),证明体内试验湘潭制槟榔与传统三联疗效基本相近. 结论:湘潭制槟榔对幽门螺旋杆菌有很强的抑菌作用.
Objective: To study the relationship between betel nut and Helicobacter pylori infection in Xiangtan.Methods: 1914 cases of industrial and mining, urban population epidemiological survey was first conducted to understand the distribution of betel nut and upper gastrointestinal symptoms.Then, from the 1914 cases were randomly selected A total of 105 patients without clinical symptoms were divided into five groups (n = 55) and non-normotensive group (n = 50). Serum samples were tested for anti-H pylori-IgG. In addition, 1814 patients with gastrointestinal symptoms were randomly divided into chewing Xiangtan A total of 956 cases of betel nut and 858 cases of chewing control group were treated by gastroscopy.All patients were examined by urethral microscopy with 2-3 specimens of antral sinus and examined by H pylori bacteriostasis in vitro In the clinical rapid urease, biopsy, smear method to find H pylori, of which two of the above three were positive H pylori positive, a total of 60 cases, divided into treatment group and control group of 30 cases, the treatment group Xiangtan betel nut daily 8-50 g, the control group with the traditional triple (bismuth + ampicillin + metronidazole), treatment 2 wk, 1mo review 14C breath test after discontinuation.Results: 1914 cases of epidemiological survey Chewing betel nut 1236 cases, 383 cases of upper gastrointestinal symptoms (accounting for 153 cases (39.34%) were relieved after chewing betel nut, 678 cases were not chewing betel nut, and 215 cases (31.71%) had upper gastrointestinal symptoms. Serum Among the 55 chewing betel nut groups, 43 (78.18%) were negative for H pylori-IgG, 12 were positive (21.82%), and 50 were anti-H pylori-IgG negative 44%), positive in 28 cases (56%) .In addition, in the 1814 cases of two groups, the positive rate of H pylori was 26.46% in the experimental group and 71.95% in the control group (P <0.005) Helicobacter pylori has obvious killing effect.Among 60 cases of H pylori infection patients, the treatment group 30 cases, of which 17 cases of H pylori negative (56.67%), 30 cases of control group H pylori negative in 21 cases (70 %), There was no significant difference between the two groups (P> 0.05), which proves that the efficacy of betel nut manufactured by Xiangtan in vivo is basically similar to that of traditional triple therapy.Conclusion: Betel nut made by Xiangtan has a strong inhibitory effect on Helicobacter pylori.