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1.
目的;观察两种三联疗法治疗幽门螺杆菌相关的十二指肠溃疡。方法:66例甲硝唑敏感的患者随机分为两组,铋剂组:po德诺240mg bid,克拉霉素500mg tid,甲硝唑400g bid,奥美拉唑组(32例):po奥美拉唑唑20mg qd,羟氨苄青霉素500mg tid,甲硝唑400mg bid。  相似文献   

2.
目的 :通过与奥美拉唑比较 ,观察雷贝拉唑三联疗法治疗十二指肠球部溃疡的疗效。方法 :5 3例患者随机分为两组 ,分别给予以雷贝拉唑 (RAC)和奥美拉唑 (OAC)为主的三联疗法 ,用药结束后复查胃镜并检测 Hp。同时于用药后 1d、2 d、3d、7d、14 d对临床症状进行评估。结果 :4 7例患者完成全部治疗方案。溃疡愈合率 :RAC组为 92 .3% ,OAC组为 76 .2 % ,RAC组高于 OAC组 ,两组之间差异有显著性 (P<0 .0 5 )。 Hp清除率 :RAC组为 85 .4 % ,OAC组为 76 .2 % ,两组之间差异无显著性。两组均能有效改善症状。结论 :两组治疗方案均能有效清除 Hp和缓解症状 ,RAC组溃疡愈合率较 OAC组为高  相似文献   

3.
AIM: To investigate the efficacy of a 1-week triple therapy with amoxycillin, clarithromycin, and omeprazole or ranitidine bismuth citrate (RBC) in curing Helicobacter pylori infection and healing duodenal ulcers. METHODS: One hundred and ninety-two consecutive out-patients with duodenal ulcer, in whom H. pylori infection was confirmed by histology and a urease biopsy test, were randomly assigned to a 1-week treatment with either 400 mg b.d. ranitidine bismuth citrate (RAC group) or 20 mg omeprazole b.d. (OAC group) in combination with 1 g amoxycillin b.d. and 500 mg clarithromycin b.d. RESULTS: Eradication of H. pylori was successful in 77% (per protocol) and 61% (intention-to-treat) of the patients in the RAC group and in 79% (per protocol) and 70% (intention-to-treat) of those in the OAC group. The difference was not significant. Per protocol analysis showed ulcers were healed in 97% of patients in the RAC group and 96% in the OAC group. Adverse effects were seen in four patients in each group: they caused discontinuation of the therapy in one patient of the OAC group. CONCLUSIONS: Eradication rates obtained in this study were lower than those expected on the basis of previously reported studies. The two 1-week treatment regimens were equally effective in healing H. pylori associated duodenal ulcer disease.  相似文献   

4.
目的:比较埃索美拉唑三联与奥美拉唑三联疗法治疗幽门螺杆菌(Hp)阳性十二指肠球部溃疡的临床疗效。方法:将124例经内镜诊断并检测证实Hp阳性的十二指肠球部溃疡患者随机分为两组。埃索美拉唑组(62例):埃索美托唑20mg加阿莫西林lg加克拉霉素500mg,每日2次,共7天;奥美拉唑组(62例):奥美拉唑20mg加阿莫西林1g加克拉霉素500mg,每日2次,共7天。疗程结束4周后胃镜检查并检测Hp,观察腹痛缓解率、溃疡愈合率、Hp根除率及药物不良反应。结果:埃索美拉唑组第一天和第二天腹痛缓解率分别为35.8%和60.2%,高于奥美托唑组的16.5%和40.3%(P<0.05)。埃索美托唑组和奥美拉唑组溃疡愈合率分别为93.6%和89.5%,Hp根除率分别为87.9%和83.7%,差异无显著性(P>0.05)。两组药物不良反应少,有较好的安全性。结论:埃索美托唑三联疗法治疗Hp阳性的十二指肠溃疡安全有效。腹痛状缓解速度明显优于奥美拉唑三联疗法。  相似文献   

5.
6.
目的观察锌剂三联疗法治疗幽门螺杆菌(Hp)相关性十二指肠溃疡疗效。方法87例患者随机分为两组。锌剂组(45例):醋氨己酸锌300mg熏2次/d熏法莫替丁20mg熏2次/d熏阿莫西林500mg熏2次/d鸦铋剂组(42例):得诺240mg熏2次/d熏法莫替丁20mg熏2次/d熏阿莫西林500mg熏2次/d。疗程均为4周。疗程结束1周后胃镜检查。结果锌剂组的Hp根除率和溃疡愈合率分别为86.87%和91.11%,铋剂组分别为88.10%和90.48%,两者比较无显著性差异(P>0.05),但平均不良反应积分铋剂组为4.36,锌剂组为2.37,两者比较有显著性差异(P<0.05)。结论两种疗法治疗Hp相关性十二指肠溃疡疗效相当,但是铋剂组不良反应发生率较高。  相似文献   

7.
AIM: To compare the efficacy and tolerability of a 3-day quadruple therapy with a standard 7-day triple therapy in eradicating Helicobacter pylori infection and healing duodenal ulcers. METHODS: Patients with H. pylori-positive duodenal ulcers were randomized to receive either lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 400 mg twice daily for 7 days (LCM-7) or lansoprazole 30 mg, clarithromycin 500 mg, metronidazole 400 mg, and bismuth subcitrate 240 mg twice daily for 3 days (LCMB-3). No pre- or post-treatment acid suppression was used. Follow-up endoscopy was performed at week 6. RESULTS: A total of 118 patients were recruited. Sixty patients in the LCM-7 group and 53 patients in the LCMB-3 group returned for endoscopy. Intention-to-treat eradication rates were 87% and 86% (P=0.94) and per protocol eradication rates were 87% and 94% (P=0.29) in the LCM-7 and LCMB-3 groups, respectively. Per protocol and intention-to-treat ulcer healing rates were 98% and 98% in LCM-7 and 100% and 91% in LCMB-3, respectively. There were no significant differences in efficacy in relation to the initial metronidazole and clarithromycin susceptibility. Significant reduction in the duration of side-effects was found in the LCMB-3 group. CONCLUSION: The 3-day quadruple therapy is highly effective, better tolerated and can be considered as a first-line therapy in duodenal ulcer management.  相似文献   

8.
目的研究埃索美拉唑三联疗法对幽门螺杆菌阳性十二指肠溃疡免疫功能及胃肠功能的影响。方法将我院收治的110例幽门螺杆菌阳性十二指肠溃疡患者纳入研究对象,采用随机数字表法分为观察组和对照组各55例,观察组患者接受埃索美拉唑三联治疗,对照组患者接受奥美拉唑三联治疗,比较2组患者的胃肠功能、免疫功能、生存质量。结果胃肠功能:观察组患者腹胀缓解时间及腹痛缓解时间短于对照组(6.23±0.84vs 10.39±1.25,3.84±0.47vs 6.91±0.88)d,溃疡愈合好转率明显高于对照组(98.12%vs 78.18%);免疫功能:观察组患者的CD3+T细胞、CD4+T细胞含量高于对照组(54.42±6.42vs 48.26±6.12,44.19±5.28vs 39.56±4.08),CD8+T细胞含量低于对照组(24.32±2.72vs 26.48±3.31);生存质量:观察组患者的物质生活维度(54.18±6.68vs 47.44±5.43)、躯体健康维度(64.52±7.51vs 51.85±6.04)、心理健康维度(67.38±7.83vs 53.48±6.14)、社会功能维度(62.22±7.87vs 53.45±6.52)评分均高于对照组患者。结论埃索美拉唑三联疗法有助于迅速缓解患者临床症状,改善胃肠功能和免疫功能,提高生存质量。  相似文献   

9.
目的观察埃索美拉唑三联疗法不同疗程治疗幽门螺杆菌(Hp)阳性的活动期十二指肠溃疡的疗效及安全性。方法 80例经胃镜证实Hp阳性的活动期十二指肠球部溃疡患者,随机分成1周疗法组(A组)和2周疗法组(B组)。A、B2组用药均为埃索美拉唑20mg、阿莫西林1.0g、克拉霉素缓释片0.5g,均每天2次。A组疗程1周,B组疗程2周。治疗过程中观察不良反应发生情况,停药4周后复查胃镜,观察溃疡愈合率,并作14C尿素呼气试验(14C-UBT)了解Hp根除率。结果 A组溃疡愈合率、Hp根除率、不良反应发生率分别为91.9%、77.5%、5.0%;B组分别为92.1%、90.0%、5.0%。A、B2组之间比较Hp根除率差异有统计学意义(P〈0.05);溃疡愈合率、不良反应发生率差异无统计学意义(P〉0.05)。结论埃索美拉唑+阿莫西林+克拉霉素三联2周疗法治疗Hp阳性的活动期十二指肠溃疡,可达到满意的Hp根除率和溃疡愈合率,且不良反应小。  相似文献   

10.

Background

Tribulus terrestris as a herbal remedy has shown beneficial aphrodisiac effects in a number of animal and human experiments. This study was designed as a randomized double-blind placebo-controlled trial to assess the safety and efficacy of Tribulus terrestris in women with hypoactive sexual desire disorder during their fertile years. Sixty seven women with hypoactive sexual desire disorder were randomly assigned to Tribulus terrestris extract (7.5 mg/day) or placebo for 4 weeks. Desire, arousal, lubrication, orgasm, satisfaction, and pain were measured at baseline and after 4 weeks after the end of the treatment by using the Female Sexual Function Index (FSFI). Two groups were compared by repeated measurement ANOVA test.

Results

Thirty women in placebo group and thirty women in drug group completed the study. At the end of the fourth week, patients in the Tribulus terrestris group had experienced significant improvement in their total FSFI (p < 0.001), desire (p < 0.001), arousal (p = 0.037), lubrication (p < 0.001), satisfaction (p < 0.001) and pain (p = 0.041) domains of FSFI. Frequency of side effects was similar between the two groups.

Conclusions

Tribulus terrestris may safely and effectively improve desire in women with hypoactive sexual desire disorder. Further investigation of Tribulus terrestris in women is warranted.  相似文献   

11.

Aim:

To evaluate the effectiveness of triple therapy containing either omeprazole or ranitidine bismuth citrate (RBC) to treat H. pylori infection in Vietnamese duodenal ulcer patients.

Methods:

Patients infected with H. pylori were randomized to receive either omeprazole (20 mg b.d.), clarithromycin (500 mg b.d.) and amoxycillin (1 g b.d.) for 10 days (OAC), or RBC (400 mg b.d.), clarithromycin (500 mg b.d.) and amoxycillin (1 g b.d.) for 10 days (RAC). H. pylori eradication and ulcer healing was established by a follow‐up oesophagogastroduodenoscopy (EGD) at least 4 weeks after therapy. Side‐effects and compliance were assessed.

Results:

One hundred and four out of 108 (96%) patients with a duodenal ulcer were infected with H. pylori. Eighty per cent of infected patients had detectable CagA IgG antibodies. Fifty‐seven patients received OAC and 47 received RAC. OAC eradicated H. pylori in 91 and 86% of patients by per protocol (PP) and intention‐to‐treat (ITT) analysis, respectively. PP and ITT eradication rates for RAC were 96 and 91%. Ulcer healing at the follow‐up EGD was 89% with OAC and 100% with RAC. Side‐effects were minor. No patient failed to complete the protocol due to side‐effects.

Conclusion:

Triple therapy with either omeprazole or RBC is highly effective in eradicating H. pylori and healing duodenal ulcer in Vietnamese patients.
  相似文献   

12.
BACKGROUND: One-week triple therapy has been suggested to be superior to two-week omeprazole-clarithromycin therapy for the cure of Helicobacter pylori infection. However, direct comparisons of the two treatments are scarce. AIM: To compare triple with dual therapy for H. pylori infection in the primary care setting. METHODS: One hundred and forty-five patients with duodenal ulcer and H. pylori infection were randomized to receive omeprazole 20 mg b.d. and clarithromycin 500 mg t.d.s. for 14 days (OC14 group, 69 patients) or omeprazole 20 mg b.d., clarithromycin 500 mg b.d. and amoxycillin 1 g b.d. for 7 days (OCA7 group, 76 patients). Eradication was evaluated by the 13C-urea breath-test. RESULTS: Intention-to-treat analysis showed a cure rate of 48% (95% CI: 36-60%) in the OC14 group, and 71% (95% CI: 59-80%) in the OCA7 group (P=0.0004). Per protocol analysis showed cure rates of 51% (95% CI: 38-63%, 33/65 patients) and 82% (95% CI: 70-90%, 54/66 patients), respectively (P=0.0001). There were no significant differences in compliance or side-effects. CONCLUSION: One-week twice-daily triple therapy is superior to 2-week dual therapy, but the cure rate in primary care was far below 90%.  相似文献   

13.

Background:

Proton pump inhibitors have been widely used in combination with amoxycillin, clarithromycin or metronidazole for the treatment of Helicobacter pylori infection.

Aim:

To study the effects of 1-week ranitidine bismuth citrate (RBC)-based triple therapy in the treatment of H. pylori-related duodenal ulcers.

Method:

Patients with duodenal ulcers and H. pylori infection were prospectively randomized to receive either RBC with amoxycillin and clarithromycin for 1 week (RAC), or omeprazole with amoxycillin and clarithromycin for 1 week (OAC). No additional ulcer healing drug was used after the 1-week medication. Patients were assessed for H. pylori eradication, ulcer healing and side-effects after receiving the therapies.

Results:

One hundred consecutive patients were recruited to this study, with 50 patients randomized to each treatment group. In the intention-to-treat analysis, duodenal ulcers were completely healed in 45 (90%) patients in the RAC group and 43 (89.6%) in the OAC group (P = 1.0). H. pylori eradication was confirmed in 47 (94%) in the RAC group and 42 (87.5%) in the OAC group (P = 0.31). There was no significant difference in the severity of side-effects experienced by the two treatment groups.

Conclusion:

One-week RBC-based triple therapy is an effective treatment for H. pylori-related duodenal ulcers. The therapeutic effects are comparable to a 1-week course of proton pump inhibitor-based triple therapy.
  相似文献   

14.
AIM: To investigate the efficacy of two omeprazole triple therapies for the eradication of Helicobacter pylori, ulcer healing and ulcer relapse during a 6-month treatment-free period in patients with active duodenal ulcer. METHODS: This was a double-blind, randomized study in 15 centres across Canada. Patients (n = 149) were randomized to omeprazole 20 mg once daily (O) or one of two 1-week b. d. eradication regimens: omeprazole 20 mg, metronidazole 400 mg and clarithromycin 250 mg (OMC) or omeprazole 20 mg, amoxycillin 1000 mg and clarithromycin 500 mg (OAC). All patients were treated for three additional weeks with omeprazole 20 mg once daily. Ulcer healing was assessed by endoscopy after 4 weeks of study therapy. H. pylori eradication was determined by a 13C-urea breath test and histology, performed at pre-entry, at 4 weeks after the end of all therapy and at 6 months. RESULTS: The intention-to-treat (intention-to-treat) analysis contained 146 patients and the per protocol (per protocol) analysis, 114 patients. The eradication rates were (intention-to-treat/per protocol): OMC-85% and 92%, OAC-78% and 87% and O-0% (O). Ulcer healing (intention-to-treat) was greater than 90% in all groups. The differences in the eradication and relapse rates between O vs. OMC and O vs. OAC were statistically significant (all, P < 0.001). Treatment was well tolerated and compliance was high. CONCLUSION: The OMC and OAC 1-week treatment regimens are safe and effective for eradication, healing and the prevention of relapse in duodenal ulcer patients.  相似文献   

15.

Background:

The eradication of Helicobacter pylori infection has been achieved using various therapy regimens, but the efficacy of the proton-pump inhibitor pantoprazole as part of these regimens has not yet been widely tested.

Aim:

To evaluate the efficacy and tolerability of a 1-week low-dose pantoprazole-based triple therapy in patients with H. pylori-positive duodenal ulcer.

Methods:

In an open single-centre prospective study, 71 patients with endoscopically proven active duodenal ulcer and H. pylori infection received pantoprazole 40 mg o.m. for 4 weeks, and during the first week a combination antimicrobial treatment comprising tinidazole 500 mg b.d. plus clarithomycin 250 mg b.d. H.?pylori eradication was defined as concordant negative histology and rapid urease test performed at endoscopy 4–6 weeks after the end of treatment, confirmed 4 weeks later by 13C-urea breath test.

Results:

Sixty-six patients (93%) completed the trial and five patients were lost to follow-up. H. pylori infection was cured in 61 out of the 66 patients who completed the trial (per-protocol analysis: 92.4%, 95% CI: 83.2–97.5%; intention-to-treat analysis: 85.9%, 95% CI: 75.7–93.0%). At final endoscopy, 65 out of 66 patients had healed ulcer (98.5%). Mild adverse events occurred in six patients (9.1%).

Conclusions:

One-week low-dose pantoprazole-based triple therapy is a simple, effective and well-tolerated regimen for ulcer healing and H. pylori eradication in patients with duodenal ulcer.
  相似文献   

16.

Background

Studies demonstrating the efficacy of short-term low-dose triple therapies including omeprazole (O), clarithromycin (C) and a nitroimidazole (tinidazole, T) for Helicobacter pylori eradication have largely been open and uncontrolled, and have not assessed antibiotic sensitivity. Simpler regimens using the component drugs have not been evaluated.

Aim

To evaluate the OCT regimen in a randomized, controlled trial, testing for pre- and post-treatment antibiotic resistance and comparing, in a factorial design, the OCT regimen with simpler combinations of its components.

Methods

One hundred and twenty-eight patients (68 males, 60 females, age 22–80 years, mean 53 years) with H. pylori gastritis were randomly assigned to one of the following four treatment groups: (C) clarithromycin 250 mg b.d.; (OC) omeprazole 20 mg o.d. + clari-thromycin 250 mg b.d.; (CT) clarithromycin 250 mg b.d. + tinidazole 500 mg b.d.; (OCT) omeprazole 20 mg q.d.s. + clarithromycin 250 mg b.d. + tinidazole 500 mg b.d. The drugs were administered for 1 week. Medical interview, upper gastrointestinal endoscopy (with four antral and four corpus biopsies) and the 13C-urea breath test were carried out for all patients prior to and 4 weeks after treatment. Biopsy specimens were used for the urease test, histology, and culture and sensitivities.

Results

All but one patient completed treatment. Side-effects were rare and mild in all groups. The eradication rate was 93.8% in group OCT, 59.4% in group CT, 31.3% in group OC and 6.3% in group C. Pre-treatment metronidazole resistance was 12.8%, clarithromycin 1.1% and, to both antibiotics, 2.1%. In patients with pre-treatment metronidazole resistance, the eradication rate was 75% in group OCT and 33% in group CT. Post-treatment resistance to clarithromycin was induced in 28.5% of the failures in group C, but in none of group OC. Resistance to both antibiotics occurred in 22.2% of the failures in group CT and in none of group OCT.

Conclusions

(i) The high efficacy of the OCT regimen is proved and each of the individual components of the regimen is essential to the result, possibly via a synergistic effect. (ii) Pre-treatment metronidazole resistance is scarcely relevant to the outcome. (iii) Acquired resistance is essentially nil if omeprazole is part of the regimen.
  相似文献   

17.
OBJECTIVE: Recent research has focused on eradication therapy as the principal treatment of patients with duodenal ulcers and Helicobacter pylori infection. The aim of this study was to analyse the cost effectiveness of triple therapy versus 2 dual therapies. DESIGN: A health economic evaluation of triple therapy with lansoprazole, amoxicillin and clarithromycin versus 2 dual therapies (lansoprazole or omeprazole, each with amoxicillin) in the eradication of Helicobacter pylori in patients with duodenal ulcers was performed in parallel with a randomised clinical trial. Direct and indirect costs were estimated for 1 year using data elicited from patient questionnaires and from the clinical trial. MAIN OUTCOME MEASURES AND RESULTS: Despite the initial drug cost for triple therapy being 650 Swedish kronor (SEK; 1996 values) higher, the average total direct cost in this group was only SEK150 to SEK200 higher than in the dual therapy groups. This was a result of fewer outpatient visits and lower drug use after treatment failure in the triple therapy group. Triple therapy had a more favourable cost-effectiveness ratio than the dual therapies. CONCLUSION: In spite of higher initial antimicrobial costs, triple therapy with lansoprazole, amoxicillin and clarithromycin is more cost effective than dual therapy because of a higher eradication rate and greater symptom relief.  相似文献   

18.
The efficacy and safety of idebenone were studied in a prospective, randomized, double-blind, placebo controlled multicentre study in 3 parallel groups of patients with dementia of the Alzheimer type (DAT) of mild to moderate degree. Diagnosis was based on DSM-III-R (primary degenerative dementia) and NINCDS-ADRDA criteria (probable Alzheimer's disease). A total of 450 patients were randomized to either placebo (n = 153) or idebenone 90 mg tid (n = 148) or 120 mg tid (n = 149) and treated up to 12 months. The primary endpoint for the evaluation of efficacy was at month 6. Data of the month-12 assessments were considered for the evaluation of long-term treatment effects. The primary outcome measure was the total score of the Alzheimer's Disease Assessment Scale (ADAS-Total) at month 6. Secondary outcome measures were the ADAS cognitive (ADAS-Cog) and noncognitive score (ADAS-Noncog), the clinical global response (CGI-Improvement), the SKT neuropsychological test battery, and the Nurses' Observation Scale for Geriatric Patients (NOSGER-Total and IADL subscale). Safety parameters were adverse events, vital signs, ECG and clinical laboratory parameters. Clinical and psychometric evaluations were made at screening, at baseline, and after 1, 3, 6, 9 and 12 months of treatment. After months 6 and 12, idebenone showed statistically significant dose-dependent improvement in the primary efficacy variable ADAS-Total and in all the secondary efficacy variables. An analysis of therapy responders performed on 3 outcome measures (CGI, ADAS-Cog, NOSGER-IADL), selected to represent different levels of assessment, revealed significant dose-related superiority of idebenone with respect to placebo in each of the 3 variables and in the concordance of responses across the 3 measures. Safety results were inconspicuous on all assessments. The study results confirm the efficacy, clinical relevance and safety of idebenone in the long-term treatment of DAT.  相似文献   

19.
BACKGROUND: The cytoprotective agent, ecabet sodium, inhibits urease activity and growth of Helicobacter pylori. AIM: To evaluate the efficacy and safety of ecabet sodium-based eradication of H. pylori infection, compared with a lansoprazole-based regimen, in a randomized multicentre study. SUBJECTS AND METHODS: A total of 120 H. pylori-positive patients were assigned to one of two treatment regimens for 2 weeks: ecabet sodium 1 g b.d., amoxicillin 500 mg t.d.s. and clarithromycin 400 mg b.d. (EAC: 60 patients); or lansoprazole 30 mg (o.m.) with the same antimicrobial agents (LAC: 60 patients). Cure of infection was assessed by a 13C-urea breath test 1 month after completion of treatment. RESULTS: One patient in the EAC group and two in the LAC group did not complete therapy because of an adverse event, and three did not undergo the 13C-urea breath test. Cure rates for the intention-to-treat, all-patients-treated and per protocol analysis in the EAC group were 85%, 86% and 88%, respectively, whereas those in the LAC group were 85%, 88% and 91%. There were no significant differences in cure rate or adverse events between the two regimens. CONCLUSIONS: Ecabet sodium in combination with amoxicillin and clarithromycin is as effective as lansoprazole-based eradication therapy for H. pylori.  相似文献   

20.
度洛西汀与帕罗西汀治疗抑郁症的多中心双盲对照研究   总被引:1,自引:0,他引:1  
目的:以帕罗西汀为对照,评价度洛西汀治疗抑郁症的疗效和安全性.方法:采用随机双盲多中心对照研究方法,244例患者纳入研究,度洛西汀组121例(60 mg·d-1),帕罗西汀组123例(20 mg·d-1),疗程8周.以汉密尔顿抑郁评定量表17项作为主要疗效评价指标.结果:度洛西汀组与帕罗西汀组的有效率分别为71.1%和...  相似文献   

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