溃疡汤联合西药治疗脾虚湿盛型十二指肠溃疡随机平行对照研究

[目的]观察溃疡汤联合西药治疗脾虚湿盛型十二指肠溃疡疗效。[方法]使用随机平行对照方法,将150例住院患者按随机数字表法分为两组。对照组75例雷贝拉唑,20mg/次,早晚餐前30min;克拉霉素,500mg/次,2次/d;阿莫西林,1g/次,2次/d。治疗组75例溃疡汤(半夏10g,黄芩、干姜、人参、灸甘草各6g,黄连3g,大枣5枚),1剂/d,水煎200mL,早晚口服;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、不良反应。连续治疗4疗程,判定疗效。[结果]治疗组痊愈28例,显效29例,有效17例,无效1例,总有效率98.67%。对照组痊愈23例,显效22例,有效18例,无效12例,总有效率84.00%。治疗组疗效优于对照组(P0.05)。[结论]溃疡汤联合西药治疗脾虚湿盛型十二指肠溃疡效果显著,值得推广。     

盆炎丸改善解脲支原体对阿奇霉素耐药的临床研究

目的观察盆炎丸改善解脲支原体对阿奇霉素耐药的临床疗效。方法将90例解脲支原体对阿奇霉素耐药患者随机分为三组,第一组口服盆炎丸,第二组口服克拉霉素,第三组口服盆炎丸＋克拉霉素,14天为一个疗程,三组均连续治疗3个疗程,观察三组治疗解脲支原体的综合疗效、对阿奇霉素耐药逆转率和中医证候疗效。结果在治疗解脲支原体的综合疗效方面,盆炎丸＋克拉霉素组优于盆炎丸组;对阿奇霉素耐药逆转率,盆炎丸组、盆炎丸＋克拉霉素组均优于克拉霉素组;在中医证候疗效方面,盆炎丸＋克拉霉素组优于盆炎丸组和克拉霉素组。结论盆炎丸可以治疗解脲支原体感染且可逆转对阿奇霉素的耐药,它无毒副作用,价格相对较低,服用方便,且不易耐药,与西药联合使用效果显著。     

Synthesis and antibacterial activity of novel 4″-O-benzimidazolyl clarithromycin derivatives

Novel 4″-O-benzimidazolyl clarithromycin derivatives were designed, synthesized and evaluated for their in vitro antibacterial activities. These benzimidazolyl derivatives exhibited excellent activity against erythromycin-susceptible strains better than the references, and some of them showed greatly improved activity against erythromycin-resistant strains. Compounds 16 and 17, which have the terminal 2-(4-methylphenyl)benzimidazolyl and 2-(2-methoxyphenyl)benzimidazolyl groups on the C-4″ bishydrazide side chains, were the most active against erythromycin-resistant Staphylococcus pneumoniae expressing the erm gene and the mef gene. In addition, compound 17 exhibited the highest activity against erythromycin-susceptible S. pneumoniae ATCC49619 and Staphylococcus aureus ATCC25923 as well. It is worth noting that the 4″-O-(2-aryl)benzimidazolyl derivatives show higher activity against erythromycin-susceptible and erythromycin-resistant strains than the 4″-O-(2-alkyl)benzimidazolyl derivatives.     

两种用药方案根除幽门螺杆菌的疗效和成本-效果分析

目的评价两种用药方案根除幽门螺杆菌（Hp）的疗效和成本-效果。方法将100例Hp阳性的消化性溃疡患者随机分为A组和B组各50例。A组采用洛赛克、阿莫西林、克拉霉素三联疗法,B组采用洛赛克、阿莫西林、呋喃唑酮三联疗法,均为口服,每日2次,疗程7d。运用药物经济学成本-效果分析方法进行评价。结果A组Hp根除率92％,B组Hp根除率78％,A纽Hp根除率明显高于B组（P〈0．05）。B组△C／△E较为理想。对比于A组仅为0．41,两组比较差异有统计学意义（P〈0．05）。结论A方案Hp根除率最高,但费用也较高,经济条件许可者可选用。B方案具有较好的Hp根除率,而且具有更好的成本一效果比,值得推广使用。     

V Conferencia Española de Consenso sobre el tratamiento de la infección por Helicobacter pylori

Helicobacter pylori infection is very common in the Spanish population and represents the main cause of chronic gastritis, peptic ulcer, and gastric cancer. The last iteration of Spanish consensus guidelines on H. pylori infection was conducted in 2016. Recent changes in therapeutic schemes along with increasing supporting evidence were key for developing the V Spanish Consensus Conference (May 2021). Fourteen experts performed a systematic review of the scientific evidence and developed a series of recommendations that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. An eradication therapy, when prescribed empirically, is considered acceptable when it reliably achieves, or preferably surpass, 90% cure rates. Currently, only quadruple therapies (with or without bismuth) and generally lasting 14 days, accomplish this goal in first- and second-line therapies. A non-bismuth quadruple concomitant regimen (proton pump inhibitor, clarithromycin, amoxicillin, and metronidazole) or a quadruple bismuth-based combination (proton pump inhibitor, bismuth, tetracycline, and metronidazole), are recommended as first-line regimens. Rescue therapies after eradication failure and management of H. pylori infection in peptic ulcer disease were also reviewed.     

Macrolide antibiotics

This article is an extensive review of current information available on the macrolide antibiotics. This includes antimicrobial spectrum, pharmacology, complications and side effects, and pediatric use of these drugs. These are important antibiotics, but careful selection of patients must be made and the physician must be alert for evidence of drug-drug interactions, which are not uncommon with several members of this class.     

雷贝拉唑、克拉霉素、阿莫西林、胶体铋剂四联治疗幽门螺杆菌感染慢性胃炎的疗效探讨

目的 探讨雷贝拉唑、克拉霉素、阿莫西林联合胶体铋剂治疗幽门螺杆菌感染的慢性胃炎患者的疗效. 方法 整群选取2013年1月—2014年12月期间该院消化内科门诊或住院患者中明确诊断为幽门螺杆菌阳性的慢性胃炎患者185例,将其随机分成治疗组(n=64)、观察组(n=59)和对照组(n=62),治疗组给予雷贝拉唑、克拉霉素、阿莫西林和胶体铋剂四联治疗,观察组给予雷贝拉唑、克拉霉素、甲硝唑、胶体铋剂四联治疗,对照组给予雷贝拉唑、克林霉素、胶体铋剂三联治疗, 比较3组患者的疗效. 结果 治疗组、 观察组、 对照组幽门螺杆菌根除率分别为92.19%(59/64)、84.75%(50/59)、76.27%(45/59),3组比较差异有统计学意义(P<0.05);治疗组、观察组、对照组消化道症状缓解率分别为89.06%(57/64)、71.19%(42/59)、为62.90%(39/62),差异有统计学意义(P<0.05);治疗组、观察组、对照组溃疡愈合率分别为90.63%(58/64)、89.83%(53/59)、80.65%(50/62),差异有统计学意义(P<0.05). 结论 雷贝拉唑、克拉霉素、阿莫西林联合胶体铋剂治疗幽门螺杆菌感染的慢性胃炎疗效较佳,幽门螺杆菌的根除率、消化道症状缓解率和溃疡愈合率均较高,值得临床推广应用.     

~(13)碳尿素呼吸试验在诊断儿童幽门螺杆菌感染及评价疗效中的应用

目的　探讨13 碳尿素呼吸试验 (13 C UBT)在诊断儿童幽门螺杆菌 (Hp)感染及评价疗效中的应用。方法　应用13 C UBT及血清Hp IgG检测 193例无症状儿童及 34 0例反复腹痛患儿Hp感染状况 ,将两项检测均为阳性的反复腹痛患儿 88例随机分为治疗组 (5 7例 )和安慰剂组 (31例 ) ,接受奥美拉唑、克拉霉素、羟氨苄青霉素 (阿莫西林 )三联治疗 ,疗程 1周。停药后 4周随访。结果　腹痛患儿13 C UBT及Hp IgG阳性率分别为 2 9.1%、5 2 .1% ,显著高于无症状儿 (11.4%、39.4% )。 2～、5～、10～ 14岁三组无症状患儿13 C UBT及Hp IgG阳性率随年龄增加 ,但差异无显著性 ,P >0 .0 5。三组患儿13 C UBT阳性率分别为 2 9%、2 9.1%、30 % ,与年龄无关 ,χ2 =0 .0 4,P >0 .0 5 ;而Hp IgG阳性率随年龄增加 (36 %、5 3.7%、70 % ) ,差异有显著性 ,χ2 =13.16 ,P <0 .0 0 5。 2～、5～ 10岁组 13 C UBT及5～、10～ 14组Hp IgG阳性率 ,腹痛患儿较无症状儿明显增高。治疗后治疗组及安慰剂组腹痛消失或好转的总有效率分别为 97%和 2 6 % ;Hp根除率分别为 88% ,10 % ,两组差异有显著性。结论　 (1)部分患儿反复腹痛与Hp感染密切相关 ,Hp感染随年龄增加 ,但症状性感染与年龄无关。 (2 ) 13 C UBT检测具有方法简单 ,准确性高 ,无损伤等     

奥美拉唑三联疗法治疗小儿消化性溃疡的临床研究

目的 探讨奥美拉唑三联疗法治疗小儿消化性溃疡的临床疗效.方法 选择2020年1月—2021年1月在新郑市中医院就诊治疗的90例消化性溃疡患儿,按照入院先后顺序将所有患儿分为对照组和治疗组,每组各45例.对照组采用雷尼替丁三联疗法进行治疗:口服盐酸雷尼替丁胶囊,3～5 mg/(kg·d),2次/d;口服克拉霉素缓释片,1...     

Seven-day triple therapy is a better choice for Helicobacter pylori eradication in regions with low antibiotic resistance

AIM: To investigate whether 7-d triple therapies are still valid in populations with low levels of resistance.METHODS: A total of 1106 Helicobacter pylori(H. pylori)-positive patients were divided into three groups,each of which received one type of 7-d triple therapy. Therapeutic outcomes of the patients were assessed by the 13C-urea breath test at 8 wk after treatment. The susceptibility of H. pylori to antibiotics was determined by an agar-dilution method. Data analysis was performed by χ2 tests.RESULTS: The eradication rates in groups A,B and C were 90.71%(332/366),90.46%(313/346) and 90.87%(189/208),respectively(P = 0.986). The resistance rates were 8.91% for clarithromycin,14.78% for levofloxacin and 0% for amoxicillin. The eradication rate was significantly different between clarithromycin-and levofloxacin-resistant patients(P 0.05) in group A. Patients whose treatment failed in group A also had a higher clarithromycin resistance rate than did successive patients(P = 0.034). However,levofloxacin resistance had no obvious influence on the eradication rate. Furthermore,three main antibiotics(clarithromycin,levofloxacin and amoxicillin) had lower DID(defined daily dose per 1000 inhabitants per day) in this city.CONCLUSION: Clarithromycin resistance is the main reason for the failure of 7-d triple therapy. In populations with low levels of resistance,a 7-d triple therapy is a viable choice. The choice of therapy should not be influenced by conditions in high antibiotic resistance regions.