雷尼替丁三联疗法对幽门螺杆菌阳性十二指肠溃疡的近期及远…

对８２例幽门螺杆菌阳性的十二指肠溃疡用雷尼替丁，羟氨苄青霉素和甲硝唑三联疗法２周，追踪１年，并与１４５例铋剂三联疗法病例对照。结果治疗组溃疡愈合率８７．８％，ＨＰ根除率８９．０％，对照组两参数为９２．４％和８５．７％（Ｐ均〉０．０５）。     

三联疗法治疗幽门螺杆菌相关性消化性溃疡疗效观察

目的：研究不含甲硝唑的短程低剂量质子泵抑制剂（ＰＰＩ）三联疗法对幽门螺杆菌（ＨＰ）根除消化性溃疡愈合的疗效。方法：采用随机双盲对照研究。将４７ 例ＨＰ阳性的消化性溃疡患者随机分为２ 组,即Ａ组（低剂量三联）采用达克普隆３０ ｍ ｇ １次／ｄ 加克拉霉素２５０ ｍ ｇ ２ 次／ｄ 加阿莫西林５００ ｍ ｇ ２ 次／ｄ,连服１０ ｄ;Ｂ组（安慰剂）采用胃舒平３片,２ 次／ｄ,连用４ 周,双盲双模拟用药。疗程结束后４ 周复查胃镜。结果：Ａ组ＨＰ根治率和溃疡愈合率分别为９３．３％ 和８６．７％ ,明显高于Ｂ组的０ 和２３．５％ （均Ｐ＜ ０．０５）。前者对症状缓解作用好、速度快,无明显副作用,患者依从性好。结论：短程低剂量ＰＰＩ三联疗法是治疗ＨＰ相关性消化性溃疡较为理想的治疗方案,尤其对甲硝唑耐药者更值得试用     

三联疗法治疗HP相关性出血性十二指肠溃疡的远期疗效观察

目的：观察三联疗法根除幽门螺杆菌（ＨＰ）,预防溃疡复发与再出血的远期疗效。方法：选择有ＨＰ感染的出血性十二指肠溃疡患者５８ 例,随机分为两组。治疗组３６ 例,用丽珠得乐冲剂、呋喃唑酮片剂、泰胃美片治疗２周;对照组２２例,单用泰胃美片治疗２周。疗程结束后,两组患者均再用泰胃美治疗２ 周,总疗程结束后４ 周及每半年复查胃镜和ＨＰ,定期随访２ 年。结果：治疗组和对照组溃疡愈合率分别为１００％ 和８１．８％ ,ＨＰ根除率分别为８０．５％ 和９．１％ 。随访２ 年后,治疗组溃疡复发率为１３．９％ ,再出血率为５．５％ ,对照组溃疡复发率为９０．９％ ,再出血率为４５．４％ ,两组溃疡复发率与再出血率比较有显著性差异（ Ｐ＜ ０．０５）。结论：三联疗法具有较好的根除ＨＰ、明显减少溃疡复发和再出血发生的作用,具有较好的远期疗效     

四联疗法对63例幽门螺杆菌阳性患者的疗效观察

目的探讨四联疗法对幽门螺杆菌（Helico bacter pylori,Hp）的根除效果。方法将123例Hp感染的患者按就诊顺序随机分为两组。观察组63例,给予口服四联疗法：奥关拉唑、胶体果胶铋、四环素、甲硝唑;对照组60例,给予口服三联疗法：奥美拉唑、阿莫西林、克拉霉素。两组均口服1周,观察服药后副反应。疗程结束后4周,复查胃镜及病理学复查。结果控制症状时间：观察组为（3．6±0．5）d,对照组（6．5±1．3）d,两组比较,差异有统计学意义（P〈0．05）;清除率：观察组为92．06％（58／63）,对照组为68．33％（41／60）。两组比较差异有统计学意义。结论观察组四联疗法的效果优于对照组三联疗法。     

瑞倍三联疗法治疗十二指肠球部溃疡及根除幽门螺杆菌的临床观察

目的 观察枸橼酸铋雷尼替丁(Ranitidine Bismuth Citrate，RBC瑞倍)为主的4周三联疗法的十二指肠球部溃疡治愈率及出门螺杆菌(Helicohbacter Pyliri，HP)根除疗效及安全性。方法将80例十二指肠球部溃疡及HP阳性患者随机分为瑞倍治疗组(A组)与奥美拉唑三联疗法组(B组)，疗程为4周。用C14呼气实验检测HP根除效果，并于疗程结束后1个月复查胃镜，评价溃疡愈合率。结果 两组HP根除率分别为：A组：95．0％，B组87．5％，溃疡治愈率为：A组：97．5％，B组：95．0％。结论 以瑞倍为主的三联疗法的溃疡治愈率和HP根除率与奥美拉唑组相似。     

雷,环,痢方案根治幽门螺杆菌感染临床疗效观察

目的 观察雷尼替丁,环丙沙星,痢特灵三联对幽门螺杆菌（Ｈｐ）阳笥的消化性溃疡,慢性胃炎患者的Ｈｐ根除率及对消化性溃疡的治疗效果。方法 经快速尿素酶试验及胃粘膜活检均确认Ｈｐ感染的消化性溃疡,慢性胃炎患者共１５５例,用雷尼替丁,环丙沙星,痢特灵三联与改良的经典三联（果胶铋,四环素,痢特灵）作随机对照治疗。     

雷尼替丁维持治疗对幽门螺杆菌相关性溃疡四联法治疗后意义的探讨

目的：观察以洛赛克为核心的两种四联疗法的幽门螺杆菌（HP）根除率和溃疡治愈率以及HP相关性胃十二指肠溃疡治愈后是否仍需应用抑酸剂维持治疗。方法：（1）196例病人（HP相关性胃炎40例,HP相关性溃疡156例）随机分两,分别给予洛赛克＋灭滴灵＋瑞贝克（庆大霉素混悬剂）＋四环素（A组）和洛赛克＋灭滴灵＋丽珠得乐＋四环素（B组）口服2周。十二指肠溃疡者继续应用洛赛克6周。胃溃疡和复合性溃疡者则继续用10周后查复查胃镜。（2）对溃疡愈合者将A与B两组各分为雷尼替丁维持组和对照组（AR^ 、AR^－、BR^ 、BR^－组）,对溃疡已愈合但HP未能根除者加用2周四联疗法后再用上述方法处理,1年后复查胃镜记录其溃疡愈合情况。结果：A组与B组的HP根除率分别为92．60％和92％和92．16（P≥0．05）,12周溃疡愈合率分别为90．54％和92．68％（P≥0．05）;AR^ 组与AR^－组组1年后溃疡持久事率分别为91．67％和58．06％（P≤0．01）,BR^ 组和BR^－组的溃疡持久愈合率分别为90．91％和53．13％（P≤0．001）,结论：（1）以洛赛克为核心的两种四联疗法均具有极高的HP根除率和极好的治疗溃疡作用。（2）HP相关性溃疡在HP根除和溃疡短期治愈后仍需用抑酸剂维持治疗。     

根除幽门螺杆菌治疗十二指肠溃疡的随机对照研究

通过根除幽门螺杆菌（Ｈｐ）治疗（不加用任何抗酸或抑酸药物）观察十二指肠溃疡（ＤＵ）的愈合率。方法：１１５例Ｈｐ感染的ＤＵ患者随机分为两组,接受７天铋剂三联治疗。Ａ组口服替硝唑５００ｍｇ、克拉霉素２５０ｍｇ和胶体次构橼酸铋２２０ｍｇ各每日２次,疗程７天,Ｂ组在Ａ组基础上加服奥美拉唑每日２０ｍｇ,疗程４周。服药前和停止抗ＨＰ治疗后４周作胃镜检查及~ （１３）Ｃ－尿素呼气试验。结果：１０７例患者完成治疗和复查,８例失访。Ａ、Ｂ两组的ＤＵ愈合率分别为９２．５％（９５％可信区间为８５．４％～９９．６％）和９６．３％（９５％可信区间为９１．３％～１００％）;两组Ｈｐ根除率分别为９４．３％（９５％可信区间为８８．１％～１００％）和９８．１％（９５％可信区间为９４．５％～１００％）,统计学上均无显著差异（＞０．０５）。服药１周内上腹痛缓解率Ｂ组明显高于Ａ组（Ｐ＜０．００５）。两组方案均未发现有明显不良反应。结论：Ｈｐ感染的ＤＵ患者经根除ＨＰ治疗,溃疡能自行愈合而不需使用抑酸药物;奥美拉唑能迅速减轻或消除ＤＵ患者的上腹痛症状;本治疗方案具有Ｈｐ根除率高、疗程短、依从性好和不良反应少等优点。     

根除老年人消化性溃疡合并幽门螺旋杆菌感染的治疗策略

目的对质子泵抑制剂（PPI）或铋剂三联疗法作为初治方案以及序贯疗法或四联疗法作为补救方案根除老年人消化性溃疡（PUA）合并幽门螺旋杆菌（Hp）感染的疗效进行比较。方法2009年7月至2010年7月间261例胃镜下尿素酶法诊断的PUA合并Hp感染患者,随机采用PPI三联疗法、铋剂三联1周疗法进行根除,观察治疗过程中不良反应发生率。PUA患者经上述抗Hp治疗后继续4周抗溃疡治疗,停药1月后复查胃镜并比较两种方法对Hp根除率及溃疡愈合率的疗效差异。对于首次三联疗法根除Hp失败者,随机应用10日序贯疗法和PPI、铋剂四联1周疗法再次行Hp根除。观察疗程中不良反应发生率,停药1个月后采用”C呼气试验观察Hp根除率。统计分析采用符合方案（PP）群组分析和意向治疗（ITT）群组分析。结果相比于铋剂三联疗法,PPI三联疗法Hp根除率（ITT：77．7％vs62．6％;PP：79．5％v564．1％;P〈0．05）及溃疡愈合率（ITT：78．5％vs64．9％;PP：80．3％vs66．4％;P〈0．05）高,不良反应发生率无明显差异（1TT：10．8％vs16．8％：PP：11．0％vs17．2％;P〉0．05）。对于首次三联疗法失败者以10日序贯疗法补救,Hp根除率较高（ITT：84．6％vJ61．5％;PP：86．8％v563．2％;P〈0．05）,且不良反应发生率较四联疗法低（ITT：12．8％VS35．9％;PP：13．2％VS36．8％;P〈0．05）。结论PPI三联1周疗法进行Hp感染根除可作为PUA患者首选,有较高的溃疡愈合率和Hp根除率;首次根除失败者可优先改用10日序贯疗法进行补救。     

止溃灭幽汤治疗幽门螺杆菌阳性活动期十二指肠溃疡的？…

目的：探讨止溃灭幽汤治疗幽门螺杆菌（ＨＰ）阳活活动期十二指肠溃疡的近期疗效。方法：自拟止溃灭幽汤治疗ＨＰ阳活活动性十二指肠溃疡６４例，并与雷尼替丁，丽珠得乐组对照，治疗６周结束时进行胃镜复查。结果：两组６周溃疡愈合效率分别为８７．２％，和９２．９％。     

奥美拉唑或兰索拉唑、阿莫西林、呋喃唑酮短程三联疗法根除幽门螺杆菌

目的探索根除率较高、价廉、安全实用的HP根除方案.方法137例消化性溃疡或糜烂性胃窦炎患者,随机分为3组A组44例,以奥美拉唑20mg+克拉霉素250mg+替硝唑500mg每天2次,疗程7天,即Bazzoli方案;B组47例,以奥美拉唑20mg+阿莫西林1000mg+呋喃唑酮100mg,每天2次,疗程7天;C组46例,以兰索拉唑30mg每天1次,阿莫西林1000mg+呋喃唑酮100mg每天2次,疗程7天.活动期溃疡患者抗HP治疗后继服奥美拉唑20mg或兰索拉唑30mg,每天1次,3周.抗HP治疗结束1月后复查胃镜并检测HP.结果A、B、C3组的HP根除率分别为90.9%、87.2%和89.1%;活动期溃疡愈合率分别为100%、93.8%和100%;糜烂性胃窦炎愈合率分别为85.2%、79.2%和92.2%;副反应发生率分别为13.6%、6.4%和8.7%.各组间差异无显著性,P＞0.05.A、B、C3组每例抗HP所需费用分别为544.5元、309.0元和170.5元.结论方案B、C是2种新的、根除率较高、价廉、安全实用的HP根除方案.     

Triple therapy for the eradication of Helicobacter pylori and reduction of duodenal ulcer relapse: Comparison of 1 week and 2 week regimens and recrudescence rates over 12 months

Abstract The aim of this study is to assess the relationship between Helicobacter pylori and the relapse of duodenal ulcer, and also to evaluate the differences in efficacy and side effects between 1 week and 2 week triple therapy. Sixty-two patients with active duodenal ulcer, which healed within 8 weeks of nizatidine treatment, were randomly allocated to one of two groups. Group 1 ( n = 29) received no drugs, Group II ( n = 33) received triple threapy for 1 week (IIa, n = 16) or 2 weeks (IIb, n = 17). Eleven patients whose ulcer did not heal after an 8 week nizatidine treatment period were randomly assigned into Group IIa ( n = 5) and IIb ( n = 6). Seven patients whose ulcer recurred after discontinuation of nizatidine were allocated to receive 2 weeks of triple therapy. All patients received endoscopy 6 weeks after entry, and again at 3, 6 and 12 months unless both ulcer recurrence and H. pylori infection were found. The frequency of ulcer relapse 6 weeks after the active duodenal ulcer had healed was 83% (24/29) in Group I, 13% in Group IIa and 14% in Group IIb. The cumulative rate of recurrence was significantly higher in Group I than in Group II (90 vs 30% at 12 months, P < 0.01). Ulcer relapse was associated with persistence of H. pylori infection ( P < 0.0001). No statistical difference was found between the 1 week and 2 week regimens in ulcer relapse rate (30 vs 30% in 1 year), H. pylori eradication rate (86 vs 100%), incidence of side effects (48 vs 53%) or recrudescence rate (17 vs 23%). Our study suggests that a 1 week regimen and a 2 week regimen are equally effective in the eradication of H. pylori and reduction of ulcer recurrence in 1 year.     

Acid suppression therapy is not required after one-week anti-Helicobacter pylori triple therapy for duodenal ulcer healing

AIM: To compare healing of Helicobacter pylori-related non complicated duodenal ulcer after one-week eradication triple therapy alone and after triple therapy with further 3-weeks antisecretory treatment with ranitidine. METHODS: Three hundred and forty three patients with symptomatic H. pylori positive duodenal ulcer were included in this randomized double-blind placebo controlled study. H. pylori infection was established by rapid urease test and histopathology of antral biopsies. All patients were treated for one week with ranitidine 300 mg b.i.d., amoxicillin 1 g b.i.d., clarithromycin 500 mg b.i.d., and then randomly treated for the following 3 weeks either with ranitidine 300 mg once daily (triple therapy + ranitidine, n =180) or placebo (triple therapy alone, n =163). Ulcer healing was assessed by endoscopy 4 weeks after inclusion. H. pylori eradication was established by (13) C-urea breath testing 5 weeks after the end of triple therapy. RESULTS: In intention to treat, duodenal ulcer healed at 4 weeks in 86 % of patients treated with triple therapy + ranitidine and in 83 % of patients treated with triple therapy alone (equivalence: 90 % CI [-3. 8 %; 9.2 %]). The H. pylori eradication rates were 67 % and 69 % respectively. Ulcer healed in 88 % of patients in whom H. pylori eradication was achieved and in 77 % of patients in whom eradication failed. CONCLUSION: These results demonstrate that one-week triple therapy alone is highly effective in healing non complicated H. pylori associated duodenal ulcer without additional antisecretory treatment.     

兰索拉唑、羟氨苄青霉素、替硝唑联合根除幽门螺杆菌的疗效观察

目的评价兰索拉唑（达克普隆）、羟氨苄青霉素、替硝唑三联疗法对幽门螺杆菌（Ｈｐ）相关性消化性溃疡的疗效。方法将８７例Ｈｐ阳性的十二指肠和（或）胃溃疡患者随机分为２组：第１组４３例,每次口服兰索拉唑３０ｍｇ、羟氨苄青霉素１０００ｍｇ、替硝唑５００ｍｇ,均每日２次,２周为一疗程;第２组４４例,给药方式同第１组,只是疗程缩短为１周,疗程结束后继续每日口服兰索拉唑３０ｍｇ,持续１周。疗程结束达４周时复查胃镜及Ｈｐ。３５例Ｈｐ根除后６个月行１４Ｃ－尿素呼气试验（ＵＢＴ）。结果第１组有３例因过敏性皮疹而退出观察,４０例用于统计学分析。第１组和第２组的Ｈｐ根除率分别为９００％和８１８％,十二指肠溃疡和胃溃疡的愈合率分别为９２５％和８８６％。６个月的Ｈｐ再感染率为８６％。结论第１组Ｈｐ根除率和溃疡愈合率均略高于第２组,两组相比差异无显著性（Ｐ＞００５）。两组均有较理想的溃疡愈合率和Ｈｐ根除率。     

Moxifloxacin-containing triple therapy after non-bismuth quadruple therapy failure for Helicobacter pylori infection

AIM: To assess the efficacy of moxifloxacin-containing triple therapy after non-bismuth quadruple therapy failure for Helicobacter pylori(H. pylori) eradication.METHODS: Between January 2010 and December 2012,we screened individuals who were prescribed non-bismuth quadruple therapy for H. pylori eradication. Among them,a total of 98 patients who failed non-bismuth quadruple therapy received 1-wk or 2-wk moxifloxacin-containing triple therapy(400 mg moxifloxacin once daily,and 20 mg of rabeprazole and 1 g of amoxicillin twice daily). H. pylori status was evaluated using the 13C-urea breath test 4 wk later,after treatment completion. The eradication rates were determined by intention-to-treat and per-protocol analyses.RESULTS: In total,60 and 38 patients received 1-wk and 2-wk moxifloxacin-containing triple therapy,respectively. The intention-to-treat and per-protocol eradication rates were 56.7%(95%CI: 45.0-70.0) and 59.6%(95%CI: 46.6-71.7) in the 1-wk group and 76.3%(95%CI: 63.2-89.5) and 80.6%(95%CI: 66.7-91.9) in the 2-wk group(P = 0.048 and 0.036,respectively). All groups had good compliance(95% vs 94.9%). Neither group showed serious adverse events,and the proportions of patients experiencing mild side effects were not significantly different(21.1% vs 13.9%). Clinical factors such as age,sex,alcohol and smoking habits,comorbidities,and presence of gastric or duodenal ulcer did not influence the eradication therapy efficacy. The efficacy of second-line eradication therapy did not differ significantly according to the firstline regimen.CONCLUSION: Two-week moxifloxacin-containing triple therapy showed better efficacy than a 1-wk regimen after non-bismuth quadruple therapy failure.Key words: Helicobacter pylori; Moxifloxacin-based triple; Non-bismuth quadruple; Second-line; Eradication     

雷尼替丁三联疗法对幽门螺杆菌阳性十二指肠溃疡的近期及远期疗效

对82例幽门螺杆菌(HP)阳性的十二指肠溃疡用雷尼替丁、羟氨苄青霉素和甲硝唑三联疗法2周,追踪1年,并与145例铋剂三联疗法病例对照。结果治疗组溃疡愈合率87.8%,HP根除率89.0%;对照组两参数为92.4%和85.7%(P均＞0.05)。治疗组副反应显著少。追踪1年,治疗组HP感染再燃9例(12.3%),重感染2例(2.7%),溃疡复发率HP阴转组1/61(1.6%),HP阳性组7/11(63.6%)(P＜0.01)。因再燃率高且在停药后4~8周发生,建议修定HP根除的标准时间,应从4周末延到8周末。     

胶体果胶铋干混悬剂治疗幽门螺杆菌阳性消化性溃疡的疗效分析

背景:对于胶体果胶铋干混悬剂治疗幽门螺杆菌(Hp)阳性消化性溃疡的疗效是否优于胶体果胶铋胶囊,目前尚无相关的临床研究。目的:比较胶体果胶铋干混悬剂与胶体果胶铋胶囊对Hp阳性消化性溃疡的临床疗效。方法:选取2012年1月~2013年4月中南大学湘雅二医院门诊初治的126例Hp阳性的消化性溃疡患者,随机分为观察组和对照组,分别给予胶体果胶铋干混悬剂+标准三联方案以及胶体果胶铋胶囊+标准三联方案,评估比较临床症状缓解情况、内镜下溃疡愈合情况以及Hp根除率。结果:观察组患者胃溃疡(84.6%对55.6%)、十二指肠溃疡(84.8%对62.1%)2周末症状消失率均显著高于对照组(P0.05),但两组4周末症状消失率无明显差异(P0.05)。观察组的溃疡治疗总有效率(98.2%对84.0%)、总体Hp的PP根除率(89.5%对72.7%)和ITT根除率(81.0%对63.5%)均显著高于对照组(P0.05)。两组均未见严重不良反应。结论:胶体果胶铋干混悬剂治疗Hp阳性消化性溃疡的疗效优于胶体果胶铋胶囊。     

Helicobacter pylori eradication as the sole treatment for gastric and duodenal ulcers

OBJECTIVES: It is uncertain whether eradication of Helicobacter pylori--without a prolonged suppression of acid secretion--is sufficient to allow healing of peptic ulcers. We evaluated whether eradication of H. pylori with no following anti-secretory medication then administered is sufficient for treatment of peptic ulcers. We also looked at the impact of non-steroidal anti-inflammatory drug (NSAID) and acetylsalicylic acid (ASA) use on ulcer relapses. METHODS: The effect of eradication on ulcer healing and relapse rate was analysed in 115 patients, randomly allocated to four treatment groups: (1) quadruple therapy (28); (2) dual therapy (n-30); (3) triple therapy (n=27); and (4) lansoprazole and placebo (n=30). Endoscopic assessment was performed at 0, 8, and 52 weeks. RESULTS: The ulcer healing rate was 100% [95% confidence interval (CI), 95-100%] in H. pylori-negative and 83% (95% CI, 67-94%) in H. pylori-positive patients (P<0.01). In patients who used NSAIDS or ASA, the healing rates was 100% (95% CI, 73-100%) and 75% (95% CI, 19-99%) in H. pylori-negative (12 patients) and H. pylori-positive patients (four patients) (P = not significant). Ulcer relapses occurred in 5% (95% CI, 1-13%) of H. pylori-negative and in 36% (95% CI, 19-56%) of H. pylori-positive patients (P < 0.01). In H. pylori-negative patients who used NSAIDs or ASA the ulcer relapse rate was 30% (95% CI, 7-65%), whereas the ulcer relapse rate was 2% (95% CI, 0.4-10%) in patients who did not use NSAIDs or ASA (P < 0.05). No difference in ulcer relapse rate in H. pylori-positive patients who used or did not use NSAIDs or ASA was found. The eradication rate of H. pylori was 93% (95% CI, 76-99%) in the quadruple therapy group, 83% (95% CI, 64-94%) in the dual therapy group, 100% (95% CI, 87-100%) in the triple therapy group, and 0% (95% CI, 0-12%) in the lansoprazole and placebo group. CONCLUSIONS: Eradication treatment for H. pylori-positive gastric or duodenal ulcer is sufficient, with no need to follow it with anti-secretory medication. Cure of the infection reduces ulcer relapses in patients who did not use NSAIDs or ASA.     

Triple Tberapy with Sucralfate Is Not Effective in Eradicating Helicobacter pylori and Does Not Reduce Duodenal Ulcer Relapse Rates

Objectives: Tbe most used therapeutic scbedule to eradicate Heticobacter pytori is the "triple therapy," which is based on the simultaneous use of a bismuth salt and two antibiotics. Sucralfate, a basic aluminum salt of sucrose sulfate, is supposed to have an antibacterial activity and is said to reduce the bacterial density of H. pytori . This randomized, prospective clinical trial compares the efficacy of an alternative oral triple therapy consisting of sucralfate, tinidazol, and tetracycline with a conventional therapy using ranitidine, with respect to H. pytori eradication and duodenal ulcer bealing and recurrence in a 12-month follow-up. Methods: Forty-three patients with active duodenal ulcers diagnosed at endos-copy were enrolled to receive either 1 g of sucralfate four times daily for 30 days, 500 mg of tetracycline four times daily, and 500 mg of tinidazol three times daily, for 10 days (group A; n = 23) or 150 mg of ranitidine twice daily for 30 days (group B; n = 20). Tbe groups were age- and sex-matched and balanced for tobacco use and H. pytori status. Compliance assessed by post-treatment interviews was considered high (all patients declared that they had ingested at least 80% of the drugs). Resutts: Both therapies were efficient in healing ulcers (group A, 95%; group B, 90%), the relapse rates were high in both groups (group A, 77%; group B, 89%), and the alternative triple therapy eradicated H. pytori in only 4% of the patients. Conclusion: Alternative oral triple therapy presented no signiflcant advantage over ranitidine treatment of active ulcer disease.