四联疗法治疗幽门螺杆菌阳性消化性溃疡疗效观察

目的观察四联疗法治疗HP阳性的十二指肠溃疡、胃溃疡HP根除率及疗效。方法经胃镜和快速尿素酶方法确诊的HP阳性十二指肠溃疡和胃溃疡共247例。予雷贝拉唑20 mg,2次/日+胶体果胶铋0.2,2次/日+克拉霉素0.5,2次/日+甲硝唑0.4,2次/日,口服一周,继而连服雷贝拉唑20 mg,一次/日共5周。疗程结束四周后胃镜及快速尿素酶试验复查。结果随访成功196例,HP总根除率81.6%,其中十二指肠溃疡根除率86%,胃溃疡根除率67.4%,溃疡病总有效率88.3%,其中十二指肠溃疡有效率89.3%,胃溃疡有效率84.8%,两组比较差异显著(P0.01)。结论含雷贝拉唑的四联疗法,对HP阳性的十二指肠溃疡HP根除及疗效优于HP阳性的胃溃疡。

Effect of quadruple therapy on peptic ulcer curative with Helicobacter pylori infection

Objective To observe the effect and eradication rate of quadruple therapy in the healing of duodenal ulcer and gastric ulcer with Helicobacter pylori infection. Methods Altogether 247 patients of duodenal ulcer or gastric ulcer with Helicobacter pylori infection which were proven by gastroscope and rapid urease method were given rabeprazole （20 mg, bid）, colloidal bismuth pectin（0.2 g, bid）, clarithromycin（0.5 g, bid） and metronidazole（0.4 g, bid）. After a week, only rabeprazole was given for 5 weeks （20 mg, qd）. At the end of the treatment, the eradication rate of Helicobacter pylori and the healing rate of ulcer were evaluated by the second endoscopey and rapid urease method. Results A total of 196 patients completed the trial. The eradication rates of H. pylori in duodenal ulcer and gastric ulcer were 86% and 67.4% ,respectively. The total eradication rate was 81.6%. The ulcer healing rates in duodenal ulcer and gastric ulcer were 89.3% and 84.8%, respectively. The total healing rates was 88.3%. There was significant difference in the eradication rate and healing rate between the duodenal ulcer and gastric ulcer （P 〈 0.01 ）. Conclusion The quadruple therapy which includes rabe- prazole showed more effect and H. pylori eradication rate in duodenal ulcer patients than gastric ulcer patients.