不同疗程三联疗法治疗幽门螺旋杆菌阳性消化性溃疡疗效观察

目的 观察不同疗程的泮托拉唑、可莫西林、克拉霉素的三联疗法治疗幽门螺旋杆菌（helicobacter pylori,HP）阳性的消化性溃疡的疗效.方法 将120例幽门螺旋杆菌阳性消化性溃疡患者,随机分为7日、10日、14日治疗三组.均采用泮托拉唑40 mg,阿莫西林1.0,克拉霉素0.5标准三联方案,每天服药两次.治疗后满4周,观察幽门螺旋杆菌根除情况、溃疡愈合情况及药物不良反应等.结果 有114例患者完成全部治疗方案.在HP根除率及溃疡愈合率方面,按意图治疗分析（ITT）和符合方案集分析（PP）.HP根除率：10日组和14日组显著高于7日组（89.7％,94.6％,71.1％,P＜0.05）,而10日组和14日组之间差异无统计学意义（P＞0.05）.溃疡愈合率：各组之间比较,差异无统计学意义（P＞0.05）.不良反应发生率：7日组和10日组不良反应发生率均低于14日组（5.3％,5.1％,24.3％,P＜0.05）;7日组和10组之间比较,差异无统计学意义（P＞0.05）.结论 10日疗法可作为本地区治疗幽门螺旋杆菌阳性消化性溃疡的较为理想方案.

The curative effect of triple therapy in different courses on helicobacter pylori of positive peptic ulcer

Objective ： To observe the curative effect of helicobacter pylori （HP） of positive peptic ulcer in different cour- ses of panxi tora azole, amoxicitlin and clarithromycin triple therapy treatment. Methods ： 120 patients with HP positive pep- tic ulcer were randomly divided into the three groups, including 7-day group, 10-day group and 14-day group. Pantoprazole 40mg, amoxicillin 1.0 and clarithromycin 0.5 standard triple solution were given twice daily. After 4 weeks of treatment, the observation of Hp eradication rate, peptic ulcer healing and adverse reaction were made. Results ： 114 patients completed treatment. Based on intention-to-treat （ITI＇） and perprotocol analysis, eradication rates of helicobaeter pylon and the heal- ing rates of peptic ulcer, helicobacter pylori eradication rates of the 10-day group and 14-day group were significantly higher than those of the 7-day group （89.7% ,94.6% ,71.1%, P 〈 0.05 ）, but there was no statistically significant difference be- tween the 10-day group and the 14-day group （P 〉 0. 05 ）. In the comparison of peptic ulcer healing rate between each group, there was no statistically significant difference （ P 〉 0.05）. The rates of adverse effects in 7-day group and 10-day group were lower than those in 14-day group （5.3%, 5. 1% ,24.3%, P 〈 0.05 ）, but there was no significant statistical difference between 10-day group and 7-day group （P 〉 0.05 ）. Conclusion： Ten day therapy is the ideal scheme of local treatment of helicobacter pylori positive peptic ulcer.