埃索美拉唑短疗程治疗十二指肠溃疡的疗效观察

目的 观察以埃索美拉唑为基础的三联短疗程治疗方案对幽门螺杆菌(Hp)阳性的十二指肠溃疡的治疗效果.方法 40例Hp阳性的十二指肠球部溃疡患者随机分为试验组和对照组,每组各20例.试验组给予埃索美拉唑20 mg、阿莫西林1000 mg以及呋喃唑酮100 mg口服,每日2次,共7 d.对照组服用奥美拉唑20 mg、阿莫西林1000 mg和呋喃唑酮100 mg,每日2次,共7 d;7 d后继续给予奥美拉唑20 mg口服,每日1次,共3周.2组患者在入选研究前和第4周后接受胃镜和快速尿素酶试验检查,观察溃疡愈合情况以及Hp根除情况并进行比较和评价.结果试验组的溃疡愈合率为90%,Hp根除率为95%;对照组分别为95%和90%.两组患者的顺应性均很好,均顺利完成了试验,两组不良反应发生率相当.结论以埃索美拉唑为基础的三联短疗程方案可有效根除Hp,促进十二指肠溃疡愈合,具有良好的经济学价值.     

雷贝拉唑治疗幽门螺杆菌阳性十二指肠溃疡的近期疗效观察——附31例报告

目的:研究雷贝拉唑治疗幽门螺杆菌(Hp)阳性十二指肠溃疡的疗效及安全性。方法:将60例经内镜证实的十二指肠溃疡Hp阳性患者随机分成雷贝拉唑组31例和奥美拉唑组29例,雷贝拉唑组第一周予雷贝拉唑10mg加阿莫西林1g加呋喃唑酮100mg,口服,每日2次;以后每日顿服雷贝拉唑10mg。奥美拉唑组第一周以奥美拉唑20mg加阿莫西林1g加呋喃唑酮100mg,口服,每日2次;以后每日顿服奥美拉唑20mg。两组疗程均为4周。停药后复查内镜观察溃疡愈合情况,记录症状改善情况及不良反应。结果:治疗后,雷贝拉唑组疼痛消失时间与奥美拉唑组比较有统计学差异(P<0.05);治疗后2周末与4周末两组的症状消失率、溃疡愈合率、总有效率比较均无统计学差异(P>0.05);雷贝拉唑组的Hp根除率稍高于奥美拉唑组,但无统计学差异(P>0.05)。雷贝拉唑组的不良反应发生率为3%,奥美拉唑组为7%。结论:雷贝拉唑对Hp阳性十二指肠溃疡有较高的治愈率和症状改善率,疗效与奥美拉唑相当,用药后患者疼痛消失时间短于奥美拉唑,雷贝拉唑抗Hp活性与奥美拉唑相似,不良反应发生率较奥美拉唑少,患者耐受性好。     

雷贝拉唑治疗幽门螺杆菌阳性十二指肠球部溃疡的疗效

目的:观察雷贝拉唑三联疗法治疗幽门螺杆菌阳性十二指肠球部溃疡的临床疗效.方法:将68例幽门螺杆菌阳性的十二指肠球部溃疡患者分为2组.治疗组38例,予雷贝拉唑10 mg、阿莫西林1 000 mg、甲硝唑400 mg,每日2次,用药7 d,7 d后予雷贝拉唑10 mg,每日1次,疗程3周.对照组30例,予奥美拉唑20 mg,阿莫西林1 000 mg、甲硝唑400 mg,每日2次,用药7 d,7 d后予奥美拉唑20 mg,每日1次,疗程3周.观察用药1 d后及7 d后症状缓解情况.疗程结束后4周复查胃镜并检测幽门螺杆菌.结果:治疗组与对照组治疗1 d后的症状缓解率分别为78.9%、46.7%,两组差异有显著性(P<0.05).两组用药7 d后症状缓解率分别为94.7%、90.0%,差异无显著性(P>0.05).治疗组与对照组溃疡愈合率分别为92.1%、90.0%,有效率分别为97.4%、96.7%,两组差异均无显著性(P>0.05).治疗组与对照组幽门螺杆菌根除率分别为89.5%、80.0%,两组差异无显著性(P>0.05).结论:雷贝拉唑治疗十二指肠球部渍疡疗效好,起效快且不良反应少.     

奥美拉唑和阿莫西林及呋喃唑酮三联短程治疗幽门螺杆菌阳性消化性溃疡的疗效观察

目的观察奥美拉唑、阿莫西林、呋喃唑酮短程三联治疗消化性溃疡的疗效及幽门螺杆菌根除率.方法48例消化性溃疡患者,予以奥美拉唑20 mg、阿莫西林1 000 mg、呋喃唑酮100mg,每日2次,疗程7日,活动期溃疡者继续每日顿服奥美拉唑20mg,连续3周.三联治疗结束1个月后,复查胃镜及钳取胃窦黏膜行快速尿素酶试验检测幽门螺杆菌.结果症状缓解率为88%(42/48)、总有效率为100%、治愈率为98%(47/48)、幽门螺杆菌根除率为94%(45/48).结论奥美拉唑、阿莫西林、呋喃唑酮短程三联治疗消化性溃疡,幽门螺杆菌根除率高,疗程短,顺从性和耐受性好.     

雷贝拉唑三联疗法对幽门螺杆菌阳性十二指肠溃疡的近期疗效观察

【目的】研究雷贝拉唑三联疗法治疗幽门螺杆菌(Hp)阳性十二指肠溃疡的疗效及安全性。【方法】将108例经内镜证实的十二指肠溃疡并Hp阳性患者随机分成雷贝拉唑组(A组)和奥美拉唑组(B组),A组:雷贝拉唑10mg, 2次/d×14d;阿莫西林1g, 2次/d×7d;呋喃唑酮100mg, 3次/d×7d。B组:奥美拉唑20mg,2次/d×14d;阿莫西林1g, 2次/d×7d;呋喃唑酮100mg, 3次/d×7d,两组均在治疗结束后4周检查胃镜、14C尿素呼气试验和胃粘膜组织病理学检查,并记录症状改善情况及不良反应。【结果】治疗开始后,A组疼痛消失时间与B组比较有统计学差异(P<0. 05),治疗结束后14d,两组的症状消失率,以及治疗结束后28d,两组的溃疡愈合率、总有效率、Hp根除率比较均无统计学差异(P>0. 05)。A组的不良反应发生率为1. 9%,B组为5. 6%。【结论】雷贝拉唑三联疗法与奥美拉唑三联疗法相比,十二指肠溃疡治愈率和Hp根除率疗效相当,但用药后患者疼痛消失时间短于奥美拉唑三联疗法,不良反应发生率较奥美拉唑三联疗法少。     

奥美拉唑联合呋喃唑酮、阿莫西林治疗幽门螺杆菌阳性消化性溃疡

目的：观察奥美拉唑联合呋喃唑酮、阿莫西林治疗幽门螺杆菌阳性消化性溃疡（PU）的效果。方法：71例幽门螺杆菌阳性消化性溃疡患者随机分为两组：治疗组36例和对照组35例。治疗组给予奥美拉唑20mg．1次／d、呋哺唑酮100mg，2次／d、阿莫西林1000mg，2次／d，饭前服用1周；对照组给予奥美拉唑20mg，2次／d、克拉霉素500mg。2次／d、阿莫西林1000mg，2次／d，饭前服用1周；两组停药4周后复查胃镜。结果：治疗组与对照组幽门螺杆菌根除率分别为83．3％、82．9％，两组比较，差异无统计学意义（P〉0．05）；治疗组与对照组治疗后总有效率分别为86．1％、85．7％，两组比较，差异无统计学意义（P〉0．05）。结论：舆美拉唑联合呋喃唑酮、阿莫西林与奥美拉唑联合克拉霉素、阿莫西林治疗幽门螺杆菌阳性消化性溃疡疗效相当，副作用少，值得临床应用。     

三联疗法治疗45例HP相关性消化性溃疡疗效分析

目的 观察三联药物在治疗幽门螺杆菌（HP）相关性消化性溃疡中的作用.方法将70例消化性溃疡患者随机分为治疗组45例和对照组25例.治疗组给予奥美拉唑20 mg,每日2次,口服,疗程4周;阿莫西林1000 mg,每日2次,口服,疗程2周;克拉霉素500 mg,每日2次,口服,疗程2周.对照组给予奥美拉唑20 mg,每日2次,口服,疗程4周.结果 治疗组溃疡愈合率,HP消除率均高于对照组,两组比较差异有统计学意义（P〈0.05）.结论 奥美拉唑、阿莫西林、克拉霉素三联药物在根除HP相关性消化性溃疡治疗中优于单一抑酸药.     

三联一周疗法治疗幽门螺杆菌相关性活动期十二指肠溃疡

目的 探讨奥美拉唑加两种抗生素采用不同方案治疗幽门螺杆菌(Hp)感染以及Hp相关性活动期十二指肠溃疡(DU)的治疗效果.方法 对52例经快速尿素酶试验及病理学Giemsa染色法检查Hp均为阳性的活动期DU患者,给予奥美拉唑20 mg、阿莫西林1000 mg,呋喃唑酮100 mg.一周治疗组(A组):2次/d,饭前1 h口服,共1周;四周治疗组(B组):2次/d,饭前1 h服用,共4周.疗程结束4周及1年对两组病人经快速尿素酶试验及病理学Giemsa染色法检查Hp.结果 疗程结束后4周及1年,两组溃疡治愈率及幽门螺杆菌根除率相比较,差异无统计学意义,而两组毒副作用发生率(分别为7.7%、26.0%)相比较,差异有统计学意义(P＜0.05).Hp根除组与Hp未根除组溃疡治愈率(分别为96.1%、56.0%)相比较;差异有统计学意义(P＜0.05).结论 由奥美拉唑、阿莫西林、呋喃唑酮三联一周疗法治疗Hp相关性活动期DU,Hp根除率高,毒副作用少,疗程短,患者依从性好,且价廉、安全、实用,值得在临床上推广应用.     

康复新液联合奥美拉唑、克拉霉素、甲硝唑治疗胃十二指肠溃疡疗效观察

目的 观察康复新液联合奥美拉唑、克拉霉素、甲硝唑治疗胃十二指肠球部溃疡临床疗效.方法 将110例胃十二指肠球部溃疡患者随机分治疗组58例,口服康复新液10 ml、奥美拉唑20 mg、克拉霉素0.25 g、甲硝唑0.2g,均为2次/d,连服10 d;对照组52例,口服奥美拉唑20 mg、克拉霉素0.25 g、甲硝唑0.2 g,均为2次/d,连服10d.10 d后均复查胃镜及HP检测.结果 治疗组愈合率93.1%,总有效率98.3%;对照组愈合率22.1%,总有效率73.1%.两组愈合率及总有效率差异有统计学意义(P<0.05).HP根除率治疗组及对照组分别为96.6%和94.2%,不良反应率治疗组及对照组分别为5.2%和5.8%,HP根除率及不良反应率差异无统计学意义(P>0.05).结论 康复新液联合奥美拉唑、克拉霉素、甲硝唑治疗胃十二指肠球部溃疡疗效高,疗程短.     

丽珠得乐治疗消化性溃疡的疗效观察

目的:探讨丽珠得乐治疗消化性溃疡的临床疗效。方法:将62例消化性溃疡患者随机分为两组:观察组33例和对照组29例。观察组采用丽珠得乐220mg,口服,2次/d,阿莫西林500mg,口服,2次/d,呋喃唑酮100mg,口服,2次/d,雷尼替丁150mg,口服,2次/d,疗程为2周;对照组采用硫糖铝1000mg,口服,3次/d,阿莫西林500mg,口服,2次/d,呋喃唑酮100mg,口服,2次/d,雷尼替丁150mg,口服,2次/d,疗程为2周。观察两组疗程结束后1周和2周时主要症状的消失率及疗程结束后2周时复查胃镜示溃疡愈合情况。结果:观察组疗程结束后1周时腹痛消失率、反酸消失率分别为62.5%、63.3%高于对照组的50.0%、53.8%(P均<0.05);观察组疗程结束后2周时腹痛消失率、反酸消失率、胃镜复查溃疡愈合总有效率分别为87.5%、86.7%、75.7%明显高于对照组的67.8%、69.2%、55.2%(P均<0.05)。结论:丽珠得乐作为胃粘膜保护剂治疗消化性溃疡效果优于硫糖铝。     

三联疗法根除幽门螺杆菌临床观察

目的：探讨枸橼酸铋雷尼替丁加左氧氟沙星加呋喃唑酮三联1周疗法根除幽门螺杆菌的疗效及安全性。方法：选择110例符合条件的幽门螺杆菌阳性慢性胃炎和消化性溃疡患者，随机分为两组。治疗组采用枸橼酸铋雷尼替丁（350mg，2次／d）加左氧氟沙星（200mg，2次／d）加呋喃唑酮（100mg，2次／d），治疗7d；溃疡患者继用枸橼酸铋雷尼替丁350mg，2次／d，3周。对照组采用奥美拉唑（20mg，2次／d）加阿莫西林（1．0g，2次／d）加甲硝唑（400mg，2次／d），治疗7d；溃疡患者继用奥美拉唑20mg，1次／d，3周。疗程结束后4周及8周复查Hp，观察幽门螺杆菌根除率、症状缓解率、溃疡愈合率及不良反应等。结果：治疗组和对照组的症状缓解率、幽门螺杆菌根除率、溃疡治愈率、不良反应发生率分别为91．8％、81．6％、90，5％、32．7％和94．0％、86．0％、95．0％、28．0％，差异无统计学意义（P〉0．05）。治疗组与对照组每例根除幽门螺杆菌费用分别为100．10元、274．68元，治疗组根除幽门螺杆菌期望成本比对照组低196．77元。结论：幽门螺杆菌加左氧氟沙星加呋喃唑酮三联1周疗法是根除幽门螺杆菌的理想方案，可作为根除幽门螺杆菌一线治疗的选择。     

低剂量呋喃唑酮三联治疗Hp阳性消化性溃疡疗效观察

【目的】探讨低剂量呋喃唑酮、阿莫西林和奥美拉唑三联治疗Hp阳性消化性溃疡的疗效及安全性。【方法】选择符合条件的96例Hp阳性的消化性溃疡患者,随机分为两组,治疗组：48例,口服呋喃唑酮100mg：阿莫西林1000mg和奥美拉唑20mg;对照组：48例,口服阿莫西林1000mg;克拉霉素500mg和奥美拉唑20mg;两组均为每天2次,抗生素疗程1周。8d后继续服用奥美拉唑20mg,每天1次,连服3周。患者在停药后4周行胃镜检查和快速尿素酶试验,观察溃疡愈合情况和Hp根除率及副作用的发生率。【结果】治疗组失访2例,对照组失访1例,根据意向治疗分析（1TT）和按治疗方案分析（PP）,治疗组和对照组的Hp根除率分别是85．4％VS87．5％和89．1％VS89．4％,两组的溃疡愈合率分别是87．5％VS 91．7％and91．3％VS93．6％,两组Hp根除率和溃疡愈合率比较差异均无显著性（P〉0．05）;两组的不良反应发生率分别是8．7％和6．4％,两组比较差异无显著性（P〉0．05）。【结论】低剂量呋喃唑酮、阿莫西林和奥美拉唑三联疗法治疗Hp阳性消化性溃疡,溃疡愈合率和Hp根除率高,副作用小,价格低廉,是一种安全有效的治疗方法。     

Results of an open multicenter study of the efficiency of one-week anti-helicobacter therapy using omeprazole, clarithromycin, and amoxicillin in patients with duodenal peptic ulcer

AIM: To study the efficiency of one-week antihelicobacter therapy using omeprazole, clarithromycin, and amoxycillin in patients with duodenal peptic ulcer during its recurrence. MATERIALS AND METHODS: 105 patients with recurrent peptic ulcer and a not less than 0.5-cm ulcer in the duodenal bulb was given triple therapy: omeprazole, 20 mg twice daily, amoxycillin, 1000 mg twice daily, and clarithromycin, 500 mg twice daily for 7 days. Then the patients were allowed to take antacids if they were required to abolish the symptoms of recurrent peptic ulcer. H. pylori was detected in the mucosal biopsy specimens taken from the anthral part and body of the stomach at gastroduodenascopy, by using the rapid urease test and histology. Gastroduodenoscopy was performed before and 4-6 weeks after the triple therapy. RESULTS: The major symptoms of recurrent peptic ulcer were eliminated in 90% of the patients by the end of a course of therapy, i.e. on its day 7. By the control time, the rate of ulcer cicatrization was 99.05% (104/105). The coincidence of results of the two tests has indicated that H. pylori eradication was 81.9% (86/105) 4-6 weeks after termination of treatment. Adverse reactions during therapy were observed in 20% of the patients; however, treatment had to be discontinued only in 2.9% of the patients. CONCLUSION: One-week triple therapy using omeprazole, clarithromycin, and amoxycillin in highly effective in treating duodenal peptic ulcer during its recurrence.     

雷尼替丁、呋喃唑酮、克拉霉素、果胶铋四联疗法治疗幽门螺杆菌阳性消化性溃疡

根除幽门螺杆菌是防治消化性溃疡的重要措施,以质子泵抑制剂(PPI)为基础的三联疗法是近年来国内外较常用的根除幽门螺杆菌方案,获得了较高的根除率,但是随着该方案广泛应用,耐药率逐年上升,且费用较高,影响了此方案的疗效。我院应用雷尼替丁、呋喃唑酮、克拉霉素、果胶铋四联疗     

Efficacy of omeprazole plus two antimicrobials for the eradication of Helicobacter pylori in a Turkish population.

Omeprazole combined with 2 antimicrobials has been suggested as a first-line option for Helicobacter pylori eradication in recent years. However, controversy exists regarding the efficacy of this protocol. This open-label, prospective clinical study investigated the efficacy of omeprazole-based triple therapy for H pylori eradication in 518 patients with H pylori-positive functional dyspepsia with or without duodenal ulcer. Amoxicillin, macrolides (clarithromycin or roxithromycin), and nitroimidazoles (metronidazole, ornidazole, or tinidazole) were the antibiotics used in the study. Nonulcer patients were randomly assigned to 1 of 8 different treatment protocols and duodenal ulcer patients were randomly assigned to 1 of 4 different treatment protocols consisting of omeprazole (20 mg once daily for nonulcer patients, 20 mg twice daily for ulcer patients for 14 days) with a combination of 2 of the above antimicrobials (for 10 days). H pylori infection was assessed by histologic findings and a rapid urease test before therapy and 4 weeks after therapy ended. Four hundred fifty-nine patients completed their regimens; 327 had functional dyspepsia (180 men, 147 women; median age, 39 years; range, 18 to 70 years) and 132 had ulcers (81 men, 51 women; median age, 40 years; range, 18 to 70 years). Eradication of H pylori was achieved in 58.8% (270 of 459) of all patients, 58.1% (190 of 327) of nonulcer dyspeptic patients, and 60.6% (80 of 132) of duodenal ulcer patients. The eradication rate varied from 47.2% to 69.4% in different treatment protocols. There were no statistically significant differences in eradication rates in any treatment group. All drugs were generally well tolerated in all groups, and no patient discontinued treatment because of side effects. Therapy with omeprazole and 2 antimicrobials for H pylori had limited efficacy in a Turkish population. The reason for these results, which conflict with those of other studies, is not clear. Further investigations of regimens for the eradication of H pylori in our population are necessary.     

Proton pump inhibitors in the treatment of peptic ulcers resistant to H2-receptor antagonists]

The aim of this study is to evaluate the therapeutic effect of proton pump inhibitors on peptic ulcers resistant to H2-receptor antagonists. Patients with ulcers resistant to at least 3 months treatment with standard or greater doses of H2-receptor antagonists were treated with 20 mg of omeprazole or 30 mg of lansoprazole, once daily, for 2 to 8 weeks. Endoscopy was performed every 2 weeks to confirm ulcer healing. Eleven of 28 (39%) gastric ulcers healed within 4 weeks and 20 (71%) within 8 weeks with omeprazole. Eight of 19 (42%) gastric ulcers healed within 4 weeks and 14 (74%) within 8 weeks with lansoprazole. All of the duodenal ulcer healed within 6 weeks with omeprazole or lansoprazole. No adverse effects were observed in this study. These results suggest that proton pump inhibitors are highly effective in the treatment of peptic ulcer resistant to H2-receptor antagonists.     

消化性溃疡幽门螺杆菌(Hp)清除前后血Hp抗体、PG、GAS 变化的研究

幽门螺杆菌(Helicobacter pylori,Hp)阳性消化性溃疡患者在Hp清除前后血清抗Hp-IgG,抗Hp-IgM,胃蛋白酶原(Pep-sinogen,PG)和胃泌素(Gastrin,GAS)水平如何?奥美拉唑,硫糖铝,罗红霉素治疗Hp感染的消化性溃疡的效果如何?本课题对上述问题进行了研究。1材料与方法1.1一般资料病例选     

埃索拉唑治疗胃食管反流病的效果观察

目的:探讨埃索拉唑治疗胃食管反流病的效果.方法:将经胃镜检查证实的96例胃食管反流病,采用随机、双盲法分成埃索拉唑组、奥美拉唑组、法莫替丁组,每组各32例.3组均予西沙比利10 mg,每日3次口服;在此基础上三组分别予埃索拉唑20 mg,每日2次口服;奥美拉唑20 mg,每日2次口服;法莫替丁20 mg,每日2次口服.于治疗8周后观察症状的缓解情况,同时复查胃镜观察食管炎治愈效果.结果:埃索拉唑组、奥美拉唑组、法莫替丁组治疗8周后症状改善总有效率分别为96.88%、93.75%、62.50%,埃索拉唑组和奥美拉唑组与法莫替丁组比较差异有非常显著的统计学意义(P＜0.01),埃索拉唑组与奥美拉唑组比较差异无统计学意义(P＞0.05);治疗8周后三组食管炎总有效率分别为87.5%、81.25%、28.14%,埃索拉唑组和奥美拉唑组与法莫替丁组比较差异具有非常显著性统计学意义(P＜0.01).结论:埃索拉唑是治疗胃食管反流病的有效药物.     

The effect of Helicobacter pylori eradication on duodenal gastric metaplasia

We investigated the incidence of duodenal gastric metaplasia and its response to Helicobacter pylori eradication in patients with duodenal ulcer or erosive duodenitis. Gastric and duodenal biopsies were taken from patients with endoscopically detected H. pylori positive duodenal ulcer or erosive duodenitis, and the presence and extent of duodenal gastric metaplasia was recorded. Patients were given omeprazole 20 mg twice daily for 2 weeks, and amoxicillin 1 g and clarithromycin 500 mg twice daily for 10 days, and then ranitidine for a further 8 weeks. Biopsies were repeated 6 months after the start of treatment. Duodenal gastric metaplasia was initially present in 22 patients (52%) and was more frequent in ulcer patients than in duodenitis patients, but not significantly so (69% versus 45%). After treatment, H. pylori was eradicated in 68% of duodenal gastric metaplasia patients and the duodenum was normal endoscopically in 85% of these patients. Duodenal gastric metaplasia was improved or eliminated in 12/15 H. pylori eradicators (80%) and in 5/7 H. pylori non-eradicators (71%), a non-significant difference. The improvement in duodenal gastric metaplasia appeared to be independent of H. pylori eradication.