三联疗法对幽门螺旋菌相关性十二指肠溃疡的疗效观察

目的 :观察雷尼替丁加克拉霉素、阿莫西林治疗幽门螺旋菌 (helicobacterpylori,HP)感染相关的十二指肠溃疡 (DU)及降低复发率的效果。　方法 :对胃镜检查为活动性DU、胃窦粘膜活检尿素酶试验及组织切片阳性的HP感染患者 96例 ,随机分为两组 ,治疗组用雷尼替丁 15 0mg ,每天 2次 ,早、晚餐前半小时服 ,克拉霉素 5 0 0mg、阿莫西林 10 0 0mg ,每天 2次 ,连服 2周。对照组用雷尼替丁 15 0mg ,每天 2次 ,早、晚餐前半小时服 ,枸橼酸铋钾颗粒剂每次 2 2 0mg ,每天 2次 ,连服 2周。治疗结束后 4周复查胃镜 ,随访 1年 ,对出现上腹痛等症状者随时复查。　结果 :溃疡愈合率 :治疗组为 95 .83 % ( 4 6/ 4 8) ,对照组为 85 .4 2 % ( 4 1/ 4 8) ,P >0 .0 5。HP根除率 :治疗组为 81.2 5 % ( 3 9/ 4 8) ,明显高于对照组 10 .4 1% ( 5 / 4 8) ,P <0 .0 1。溃疡愈合患者 1年后复发率 :HP根除组为 9% ( 4 / 4 4 ) ,明显低于HP未根除组 69.2 3 % ( 3 6/ 5 2 ) ,P <0 .0 1。　结论 :雷尼替丁加克拉霉素、阿莫西林对治疗HP感染相关的DU及降低复发率 ,疗效显著 ,价格合理 ,是可供临床选择的治疗方案之一。

Efficacy of triple therapy in the treatment of duodenal ulcer with helicobacter pylori infection

Objectives:To evaluate the curative effect and the recurrence rate of duodenal ulcer(DU) with helicobacter pylori (HP) infection with ranitidine, kromycin and amoxycillin. Methods:From January 1998 to December 1999, ninty six DU patients with HP infection were selected. Duodenal ulcers were verified by gastroscopy, HP infection was identified by urase test. Patients were randomized into two groups(treated group n=28 , control group n=28 ). Treatment group received 150 mg of ranitidine, 500 mg of kromycin and 1 000 mg of amoxycillin anteprandially twice daily. The course was two weeks. Control group received 150 mg of ranitidine and 220 mg of bismuth potassium citrate granules twice daily. The course was also two weeks. All the patients were evaluated by gastroscopy and followed up for one year. Results:The cured rate in the treatment group was 95.83%(46/48), HP eradication rate was 81.25%(39/48). The cured rate in the control group was 85.42%(41/48), P > 0.05 , HP eradication rate was 10.41%(5/48), P <0.01. On follow up one year later, the recurrence rate of those HP eradicated(9%) was much lower than those uneradicated(69.23%), P <0.01. Conclusions:Ranitidine, kromycin and amoxycillin are effective in the treatment of DU with HP infection. It also reduces the recurrence rate obviously, and is clinically valuable.