阿莫西林克拉维酸钾联合方案与阿莫西林联合方案对消化性溃疡及根除HP疗效比较

目的比较阿莫西林克拉维酸钾联合治疗方案与阿莫西林联合治疗方案对消化性溃疡及根除幽门螺旋杆菌的疗效。方法选取我院门诊经胃镜及病理学检查确诊为消化性溃疡患者,经碳呼气试验确诊幽门螺旋杆菌感染385例,男224例,女161例,年龄17～74岁,平均年龄（34.8±14.4）岁,随机分为两组：治疗组193例,男115例,女78例;年龄18～74岁（平均35.2±14.7）岁。治疗方案为：埃索美拉唑20 mg,2次/d,克拉霉素500 mg,2次/d及阿莫西林克拉维酸钾分散片1 125 mg,2次/d,7 d后继续埃索美拉唑20 mg,2次/d,21 d。对照组192例,男109例,女83例;年龄17～65岁（平均34.5±13.6）岁。对照组为：埃索美拉唑20 mg,2次/d,克拉霉素500 mg,2次/d及阿莫西林1 000 mg,2次/d,7 d后继续埃索美拉唑20 mg,2次/d,21 d。结果治疗组和对照组的症状缓解率分别为97.9%和92.2%,溃疡愈合率分别为90.2%和85.4%,HP根除率分别为90.7%和82.3%。经比较均无统计学差异（P〉0.05）。主要不良反应均是轻微可接受的。结论虽然阿莫西林克拉维酸钾联合治疗方案在症状缓解率、溃疡愈合率、HP根除率优于对照组,但是差异无统计学意义（P〉0.05）。故是否应用阿莫西林克拉维酸钾代替阿莫西林根除HP尚有待进一步研究。

Comparison of therapeutic effects of amoxicillin clavulanate potassium combination drug therapy and amoxicillin combination drug therapy on peptic ulcer and the eradication of H.pylori

Objective To compare therapeutic effects of amoxicillin clavulanate potassium combination drug therapy and amoxicillin combination drug therapy on peptic ulcer and the eradication of H.pylori.Methods We diagnosed patients with peptic ulcer by endoscopy and pathology,the carbon breath test confirmed H.pylori infection in 385 cases,including 224 males and 161 females,the main age distributing were 17～74 years old,average age was（34.8±14.4）.193 patients in treatment group including 115 males and 78 females,the main age distributing were 18～74 years old,average age was（35.2±14.7）.Therapeutic schedule： esomeprazole 20mg,twice daily,clarithromycin 500mg,twice daily,amoxicillin clavulanate potassium disperse tablets 1 125mg,twice daily.After 7d,continue to use esomeprazole 20mg,twice daily for 21d.192 patients in control group including 109 males and 83 females,the main age distributing were 17～65 years old,average age was（34.5±13.6）.Therapeutic schedule： esomeprazole 20mg,twice daily,clarithromycin 500mg,twice daily,amoxicillin 1 000mg,twice daily.After 7d,continue to use esomeprazole 20mg,twice daily for 21d.Results The symptom alleviation rate of treatment group and control group were 97.9% and 92.2%;ulcer healing rate were 90.2% and 85.4%,HP eradication rate were 90.7% and 82.3%,respectively.There was no statistic difference between comparisons（P〉0.05）.The main adverse effect is mild.Conclusion The treatment group in symptom alleviation rate,ulcer healing rate,HP eradication rate are better than the control group,but the difference showed no statistical significance（P〉0.05）.Whether amoxicillin clavulanate potassium would replace amoxicillin should be study further.