药物治疗幽门螺杆菌相关性溃疡疗效分析

目的评估雷贝拉唑、克拉霉素、阿莫西林三联疗法治疗幽门螺杆菌（Helicobacter pylori,Hp）相关性溃疡的疗效。方法86例经胃镜检查确诊的消化性溃疡患者,并经快速尿素酶法和组织学测定为Hp阳性,随机分为雷贝拉唑组（46例）和奥美拉唑组（40例）。两组分别予以三联疗法：雷贝拉唑20 mg或奥美拉唑20 mg,每日2次;克拉霉素0.5 g,每日2次;阿莫西林1.0 g,每日2次。经2个疗程（14 d）结束后分别单独使用雷贝拉唑20 mg或奥美拉唑20 mg,每日1次连续2个月,分别记录用药第1、3、10月患者症状改善程度,停药后1月复查胃镜及Hp,观察溃疡愈合和Hp根除情况。结果雷贝拉唑组第1、3月症状缓解率分别为65.2%和93.5%;奥美拉唑组为20.0%和45.0%,两组差异有显著性（P〈0.05）。雷贝拉唑组溃疡治愈率为95.7%,奥美拉唑组为72.5%,两组比较差异有显著性（P〈0.05）。雷贝拉唑组Hp根除率为97.8%,奥美拉唑组为90.0%,两组无统计学差异（P〉0.05）。结论雷贝拉唑三联疗法治疗Hp相关性溃疡,溃疡愈合迅速、症状消失快,治疗...更多中雷贝拉唑组在症状缓解率及溃疡愈合方面更具优势。

Clinical analysis of drug treatment of Helicobacter pylori-related peptic ulcer

Objective To evaluate the efficacy of Rabeprazole and Omeprazole based triple therapy regimens in the treatment of Helicobacter pylori（Hp）-related peptic ulcer.Methods Eighty-six cases with documented peptic ulcer and Hp infection confirmed by endoscopic examination and rapid urease test were randomized to receive Rabeprazole（46 cases） or Omeprazole（40 cases） based triple therapy regimens for 14 days,including that Rabeprazole or Omeprazole 20 mg,Clarithromycin 0.5 g,and Amoxicillin 1.0 g,two times one day,followed by single use of Rabeprazole or Omeprazole 20 mg,one time per day for two months.Endoscopic examination and rapid urease test were repeated four weeks after the end of the treatment,and the degree of patients＇ symptomatic relief after medication were recorded.Results Symptomatic relief rate was 65.2%、93.5% in Rabeprazole group and 20.0%、45.0% in Omeprazole group at day 1 and 3,respectively,with a significance distinction between the two groups（P〈0.05）.The ulcer healing rate was 95.7% in Rabeprazole group and 72.5% in Omeprazole group（P〈0.05）.Hp eradication rate was 97.8% in Rabeprazole group and 90.0% in Omeprazole group,but there was no significant difference between the two groups（P〉0.05）.Conclusion Rabeprazole based triple therapy regimen to treat Hp-associated peptic ulcers is the primary choice regarding ulcer healing rate and symptomatic relief.The preponderance of symptomatic relief and ulcus healing rate are obvious on Rabeprazole in comparison with Omeprazole.