雷贝拉唑三联一周疗法根除幽门螺杆菌疗效观察

目的:观察雷贝拉唑三联一周疗法在十二指肠球部溃疡中对幽门螺杆菌(Hp)的根除作用和溃疡愈合的疗效.方法:Hp阳性的十二指肠球部溃疡患者79例,随机分成两组.观察组38例用雷贝拉唑10mg、羟氨苄青霉素1.0g和克拉霉素0.5g,每日2次,口服.治疗1周后不再加用其他药物;对照组用奥美拉唑20mg替代雷贝拉唑,余与观察组相同,治疗1周后继续以奥美拉唑20mg,每天1次,口服3周.疗程结束后6周,观察临床症状的改变、溃疡愈合和Hp根治情况以及治疗过程中出现的不良反应.结果:观察组在前7天疼痛症状的改善优于奥美拉唑组;观察组溃疡愈合率和有效率分别为97.4%和100%,对照组分别为92.3%和100%,两组愈合率和有效率相似(P＞0.05);两组Hp根除率分别为89.5%和87.8%,组间差异无显著性意义(P＞0.05);观察组不良反应发生率7.9%.对照组9.8%,P＞0.05.结论:雷贝拉唑三联1周疗法能安全、有效地根除幽门螺杆菌和促进溃疡愈合.     

雷贝拉唑、呋喃唑酮、加替沙星三联疗法根除幽门螺杆菌感染的疗效观察

目的:研究雷贝拉唑、呋喃唑酮、加替沙星三联疗法根除幽门螺杆菌(Hp)感染的疗效、不良反应和药品的费用,探讨更佳的Hp根除方案。方法:选择符合条件的200例患者,随机分为两组。治疗组:雷贝拉唑10mg,2次/d,呋喃唑酮100mg,2次/d,加替沙星200mg,2次/d。对照组使用雷贝拉唑10mg,2次/d,甲硝唑200mg,2次/d,阿莫西林500mgbid。疗程均为1周。停药4周复查胃镜或14C-UBT。结果:治疗组、对照组Hp根除率分别为93%、88%,差异无统计学意义(P>0.05)。未见严重的不良反应。治疗组、对照组的治疗费用分别为111元、87元。结论雷贝拉唑、呋喃唑酮、加替沙星三联疗法能有效、安全地根除Hp且费用较低。     

不同剂量三联疗法根除幽门螺杆菌疗效比较

目的观察不同剂量三联方案7日疗法根除幽门螺杆菌(H.pylori)的疗效。方法收集216例H.pylori阳性的消化性溃疡或慢性胃炎患者,随机分为4组:RCA(小剂量)组、RCM(小剂量)组、RCA组及RCM组分别给予含克拉霉素0.25及0.5的三联方案治疗7 d,各组慢性胃炎患者疗程结束后停用所有药物,消化性溃疡患者停用抗生素后继续口服雷贝拉唑4～6周。所有受试者停用抗生素至少4周并停用PPI至少2周后复查14C-UBT。结果①4组H.pylori根除率按ITT分析分别为77.78%、55.56%、83.33%及55.56%,按PP分析分别为82.35%、65.95%、90.00%及68.18%,RCA组H.pylori根除率高于RCA(小剂量)组差异有显著性(P<0.05);②4组患者溃疡愈合情况、症状缓解率及不良反应发生率均差异无显著性(P>0.05);③RCA(小剂量)组、RCM(小剂量)组较RCA组及RM组方案治疗成本及C/E比值低,RCA(小剂量)组和RCA组三联7日疗效优于RCM(小剂量)组及RCM组,能有效根除H.pylor(iP<0.05),RCA组优于RCA(小剂量)组(P<0.05)。结论 RCA(小剂量)组和RCA组三联7日疗法均能有效根除H.pylori,且副反应小,病人依从性好,且RCA(小剂量)组及RCA组有望成为一线H.pylori根除方案,尤其是RCA组。     

雷贝拉唑、左氧氟沙星和阿莫西林根除幽门螺杆菌疗效观察

目的探讨左氧氟沙星三联疗法根除幽门螺杆菌（Hp）的疗效及安全性。方法选择80例符合条件的Hp阳性患者采用雷贝拉唑（10mg,2次/d）、左氧氟沙星（400mg,1次/d）和阿莫西林（1000mg,2次/d）治疗7d。疗程结束4周后复查碳-14尿素呼气试验,观察rip根除率和不良反应。结果治疗组意图治疗（ITT）和试验方案分析（PP）Hp根除率分别为87．5％和93.3％。其中3例出现不良反应。结论雷贝拉唑、左氧氟沙星和阿莫西林三联方案治疗Hp感染是一种高效、安全的理想方案,而且不良反应少,依从性好,费用少,值得推广。     

雷贝拉唑三联疗法治疗幽门螺杆菌相关性胃溃疡100例

目的 观察雷贝拉唑三联疗法治疗幽门螺杆菌(Helicobacter pylori,H.pylori)相关性胃溃疡的临床疗效及对H.pylori的根除情况.方法 2008年6月-2010年6月,H.pylori相关性胃溃疡患者200例随机分为2组,观察组100例采用雷贝拉唑三联疗法,对照组100例采用奥美拉唑三联疗法,比...     

雷贝拉唑三联法根除幽门螺杆菌感染的Meta分析

目的 分析评价雷贝拉唑三联疗法根除幽门螺杆菌的有效性和安全性.对象和方法公开发表的、以幽门螺杆菌阳性患者为对象的、评价雷贝拉唑三联法临床试验的中文文献.利用微机检索中国期刊全文数据库(CNKI).以雷贝拉唑三联法为试验药,奥美拉唑为阳性对照药,运用Meta分析方法,对10个采用随机平行对照的独立临床试验结果进行综合的数量化分析、亚组分析、敏感性分析、药物经济学分析和文献发表偏性分析等.结果 雷贝拉唑组对幽门螺杆菌的根除率及溃疡愈合率显著优于奥美拉唑组,合并效应量OR分别为1.96、3.07,95%CI分别为(1.24,3.09)和(2.18,4.32)(P＜0.05).在症状缓解和消失方面,两组治疗在第1天和第3天有显著性差异,雷贝拉唑组起效迅速,症状缓解显著,5d后两组无显著差异.两组间不良反应率无显著差异.结论 较之奥美拉唑,雷贝拉唑三联疗法具有剂量小、疗程短、症状消失快、Hp根除率高、溃疡愈合迅速、副作用小等优点,用其根除幽门螺杆菌感染是有效的和安全的.     

雷贝拉唑三联疗法根除幽门螺旋杆菌感染疗效观察

[目的]观察雷贝拉唑三联短程疗法根除幽门螺旋杆菌以及在十二指肠球部溃疡愈合中的疗效。[方法]将90例经电子胃镜检查确诊为十二指肠球部溃疡,并且经快速尿素酶试验确定为HP阳性的患者,随机分成治疗组和对照组。治疗组45例,采用雷贝拉唑,羟氨苄青霉素,克拉霉素治疗。对照组45例,采用奥美拉唑,羟氨苄青霉素治疗。疗程结束后4周,复查胃镜并检测HP,记录患者症状改善程度、溃疡愈合率以及HP根除情况。[结果]90例均完成治疗方案,治疗组溃疡愈合率、有效和HP根除率分别为97.8%、100%和88.9%,对照组溃疡愈合率、有效率和HP根除率分别为93.3%、100%和86.7%,两组间愈合率、有效率和HP根除率差异无显著意义(P>0.05)。[结论]雷贝拉唑三联1周疗法在十二指肠球部溃疡病人中有很高的HP根除率和溃疡愈合率。     

雷贝拉唑或艾美拉唑为基础的三联治疗方案根除幽门螺杆菌感染的疗效比较

目的:比较以雷贝拉唑或艾美拉唑为基础的三联治疗方案根除幽门螺杆菌(Helicobacter pylori,Hp)感染的安全性和有效性。方法:随机抽取381例Hp感染患者分为2组,A组190例,使用艾美拉唑40 mg每天1次,阿莫西林1 g每天2次,克拉霉素500 mg每天2次,疗程7 d;B组191例,使用雷贝拉唑20 mg每天2次,阿莫西林和克拉霉素的用法及疗程同A组。完成治疗后12～16周胃镜随访。拒绝胃镜检查的患者使用14C-呼气试验判断治疗效果。结果:A组根除Hp 170例,根除率为89.5%;B组根除173例,根除率为90.6%,差异无统计学意义(P0.05)。A组不良反应发生率为4.21%,B组为6.81%,差异无统计学意义(P0.05)。结论:以雷贝拉唑或艾美拉唑为基础的三联治疗方案根除Hp感染均有较好的安全性和有效性。     

雷贝拉唑与奥美拉唑根除幽门螺杆菌306例体会

目的：探讨雷贝拉唑与奥美拉唑根除幽门螺杆菌（ Hp）的对比研究。方法：回顾性分析我院2011年1月～2013年8月收治的306例Hp感染患者,分别采用雷贝拉唑10 mg＋胶体次枸橼酸铋220 mg＋阿莫西林1．0 g＋克拉霉素500 mg;奥美拉唑20 mg＋胶体次枸橼酸铋220 mg＋阿莫西林1．0 g＋克拉霉素500 mg口服治疗14天,治疗后Hp的根除情况。结果：对比研究后发现根除Hp雷贝拉唑要优于奥美拉唑。结论：雷贝拉唑理应作为根除Hp一线用药和补救方案的首选质子泵抑制剂。     

Helicobacter pylori infection in non-ulcer dyspepsia: A cross-sectional study

BackgroundHelicobacter pylori infection has been known to be associated with dyspepsia for more than two decades; however, studies on this topic in India are limited. This study was carried out to estimate the Helicobacter pylori infection rates in non-ulcer dyspepsia.MethodsHelicobacter pylori infection rates detected by rapid urease test (RUT) positivity were analyzed in 235 patients presenting to a tertiary care center with dyspepsia having no evidence of peptic ulcer disease on esophagogastroduodenoscopy.ResultsIn this study, the prevalence of Helicobacter pylori infection diagnosed by the RUT was found to be 40.85%. Gender-based prevalence was found to be 40.14% and 41.93% for men and women, respectively. The highest prevalence was found in the age group of 30–39 years. The most common area of involvement was the isolated antrum of the stomach as seen in 93 patients.ConclusionThis study shows a modest RUT positivity rate for Helicobacter pylori infection with the commonest site of involvement being the antrum of the stomach. Further studies will be needed to assess the prevalence of Helicobacter pylori in the community to analyze the extent of infection.     

两种四联疗法治疗幽门螺杆菌阳性消化性溃疡疗效比较

【目的】比较雷贝拉唑与兰索拉唑四联疗法治疗幽门螺杆菌(Helicobacter pylori,Hp)阳性消化性溃疡(pepticulcer,PU)疗效。【方法】将Hp阳性PU 240例分为2组,治疗组124例,予雷贝拉唑10 mg,丽珠得乐220 mg,阿莫西林1 000 mg,呋喃唑酮100 mg,2周。再服雷贝拉唑10 mg,2周。对照组116例,予兰索拉唑30 mg,丽珠得乐220 mg,阿莫西林1 000 mg,呋喃唑酮100 mg,2周。再服兰索拉唑30 mg,2周。停药1个月后复查胃镜检测Hp。【结果】治疗组疼痛消失时间(1.3±0.6)d与对照组(2.2±1.0)d比较有统计学差异P<0.05);治疗4周末2组症状消失率均为100%,溃疡愈合率98%、97%,均无统计学差异P>0.05)。治疗组Hp根除率97%,对照组91%,无统计学差异(P>0.05)。【结论】2组疗法均能有效治疗PU、根除Hp。雷贝拉唑在快速改善疼痛症状方面优于兰索拉唑(P>0.05)。     

根除幽门螺杆菌——谁会受益？主要是内镜证实的消化性溃疡或功能性消化不良患者

消化不良（dyspepsia）最新的定义是指明显的上腹部疼痛至少持续4周，伴或不伴有烧心。胃-食道反流性疾病（gastro—oesophageal reflux disease，GORD）则是指以烧心为突出症状。当内镜检查排除消化性溃疡后，这两个定义是实用及合理的，但对于尚未进行内镜检查的患者，这两个定义就不能充分说明问题。因此，2004年英国国立临床卫生优选研究所（National Institute for Health and Clinical Excellence，     

抑酸与抗幽门螺杆菌在消化性溃疡治疗中的地位分析

目的 评价根除幽门螺杆菌在ＨＰ阳性消化性溃疡治疗中的地位。方法 共纳入６５例病人,胃镜下证实有消化性溃疡及Ｈｐ感染,随机分为两组。Ａ组采用四联疗法,奥美拉唑２０ｍｇ＋胶体次枸橼酸铋２４０ｍｇ＋甲硝唑４００ｍｇ＋四环素５００ｍｇ,每天２次,疗程１周。Ｂ组采用三联疗法,即从以上方案中去除奥美拉唑,其余不变。停药４周后复查,评价ＨＰ根除（组织学、ＲＵＴ、＾１４Ｃ－尿素呼吸试验同时阴性）及溃疡愈合情况。结     

A comparison of symptoms between non-ulcer dyspepsia patients positive and negative for Helicobacter pylori.

The role of Helicobacter pylori infection in the symptom complex associated with non-ulcer dyspepsia is uncertain, despite the presence of the organism in a high proportion of these patients. In order to exclude physician bias in history taking, 18 patients (9 female) diagnosed as non-ulcer dyspepsia, after endoscopy and gallbladder ultrasonography, underwent computer interrogation using the Glasgow Diagnostic System for Dyspepsia (GLADYS). Five antral and 3 fundal endoscopic biopsies from these patients were also histologically examined for the presence of Helicobacter pylori and quantitatively analysed for polymorph and chronic inflammatory cell densities per mm2 of lamina propria using computer-linked image analysis. In the group of 9/18 patients who were positive for Helicobacter pylori, there were significantly higher antral and fundal inflammatory cell counts than in negative patients. However, analysis of the GLADYS interrogation data showed no significant positive relationships between Helicobacter pylori positivity and any gastrointestinal symptoms. These results confirm a significant association between Helicobacter pylori and superficial gastritis but suggest that non-ulcer dyspepsia in patients with Helicobacter pylori colonisation is probably not a clinically identifiable and distinct syndrome.     

根除幽门螺杆菌对儿童腹型过敏性紫癜疗效的研究

目的 探讨根除幽门螺杆菌（H.pylori）对儿童腹型过敏性紫癜（HSP）的临床疗效.方法 选择130例已确诊为腹型HSP住院患儿,采用13C-UBT进行H.pylori检测,阳性者85例,分为治疗组45例和对照组40例.对照组给予常规治疗方案,治疗组在此基础上加用根除H.pylori三联治疗,比较其疗效及复发率.结果 治疗组有效率为95.6%,对照组有效率为72.5%,2组比较差异有统计学意义（P＜0.05）;治疗组胃肠道症状缓解迅速,复发率为8.9%,而对照组为30%,2组差异有统计学意义（P＜0.05）.结论 H.pylori感染与儿童腹型HSP密切相关,对于H.pylori阳性者给予根除H.pylori治疗,可有效提高疗效,降低复发率.     

四联疗法根除幽门螺杆菌感染对肝源性溃疡的影响

目的　研究肝硬化合并消化性溃疡 (Hepatogeniculcer ,HU)的临床特点和四联疗法的治疗效果。方法　肝硬化合并消化性溃疡 10 5例 ,内镜检查了解溃疡合并出血发生情况及四联疗法治疗后溃疡愈合情况 ,并与同期消化性溃疡(Pepticulcer,PU)疗效对比分析。同时胃粘膜活检作尿素酶实验检测幽门螺杆菌。结果　HU患者溃疡部位以十二指肠溃疡居多 ,合并出血率高。HU组和PU组溃疡愈合率分别为 65 7%和 88 5 %。随访 2年后 ,HU组溃疡复发率为 68 4% ,再出血率为 3 0 2 % ,PU组溃疡复发率为 48 9% ,再出血率为 16 6% ,两组溃疡复发率与再出血率比较有显著性差异 (P <0 0 1)。HU患者Hp阳性率为 72 4%。根除Hp可明显提高肝硬化合并消化性溃疡的愈合率 ,降低溃疡复发率与再出血率。结论　肝硬化合并消化性溃疡较难治愈 ,且易合并出血 ,根除HP有助于肝硬化合并消化性溃疡的愈合     

Demographic and endoscopic characteristics of patients with Helicobacter pylori positive and negative peptic ulcer disease

OBJECTIVE: To identify demographic and endoscopic characteristics of patients with Helicobacter pylori positive and negative chronic peptic ulcer disease. DESIGN: Cross-sectional study of peptic ulcer disease in prospectively recruited PATIENTS undergoing gastroscopy. PATIENTS: 277 consecutive patients referred for gastroscopy in 1996-1998. MAIN OUTCOME MEASURES: Rapid urease test, culture and histological examination for H. pylori infection; anti-H. pylori IgG antibodies in serum; demographic data, intake of non-steroidal anti-inflammatory drugs (NSAIDs) in the preceding 3 months, and size, number and location of ulcers. RESULTS: 54 patients (19%) had evidence of peptic ulcer disease (34 gastric ulcer, 14 duodenal ulcer and 6 both gastric and duodenal ulcer); 45 had active chronic peptic ulcer disease and were analysed in detail. H. pylori was present in 25 (56%) of these patients; 10 (22%) had used NSAIDs and 7 of the NSAID group also had H. pylori infection. Of the patients with gastric ulcers, those with non-H. pylori, non-NSAID ulcers were significantly younger than both those with H. pylori-associated ulcers (mean age, 48 v. 65 years, P = 0.02) and those with NSAID-associated ulcers (mean age, 48 v 68 years, P = 0.02). The average size and number of gastric ulcers did not differ between patients with and without H. pylori infection. Of patients with duodenal ulcers, those with H. pylori infection had significantly fewer ulcers (1.1 v. 1.8, P = 0.04), although ulcer size was similar in the infected and uninfected groups. CONCLUSIONS: Gastric ulcers may now be more common than duodenal ulcers. Gastric ulcers associated with H. pylori infection and/or NSAID use occurred mostly in older people, while non-H. pylori, non-NSAID gastric ulcers were more common in younger patients. In the duodenum, single ulcers were associated with H. pylori infection, and multiple ulcers were more frequent in the non-H. pylori, non-NSAID group.     

参麦注射液联合抗幽门螺杆菌治疗消化性溃疡的临床研究

目的探讨参麦注射液联合抗幽门螺杆菌（helicobacter pylori,Hp）治疗消化性溃疡（pepticulcer,PU）的疗效及对其预后的影响。方法收集PU患者50例,随机分为三联抗Hp组（对照组）和参麦注射液联合三联抗Hp组（治疗组）,每组25例,观察指标为临床症状缓解、溃疡愈合及复发情况。结果临床症状缓解率、溃疡总治愈率、Hp转阴率和复发率在治疗组分别为96％、96％、88％和8％,对照组分别为84-3％、80．0％、76％和16％,两组比较差异有统计学意义（P〈0．05）,治疗组胃镜检查结果改善与对照组比较差异有统计学意义（P〈0．05）。结论参麦注射液联合抗Hp治疗消化性溃疡可提高疗效,减少复发;推测参麦注射液有改善胃肠黏膜循环和增强屏障功能。促进溃疡修复和愈合作用。     

复发性口腔溃疡与幽门螺杆菌所致消化性溃疡的相关性研究

目的探讨复发性口腔溃疡（recurrent aphthous ulcer,RAU）与幽门螺杆菌（Helicobacter pylori,HP）及消化性溃疡的相关性。方法采用聚合酶链反应（PCR）法分别检测128例RAU患者及128例健康对照组口腔HP阳性率情况,13C呼气试验检测54例HP阳性的RAU患者抗HP的三联药物治疗组和常规抗炎治疗组的治疗效果。结果 128例RAU患者和128例健康人群HP的阳性率分别为42.2%和15.9%（P〈0.01）,128例RAU患者和128例健康人群中,伴有胃肠道疾病的和未伴有消化性溃疡的比例分别为25.0%和9.4%（P〈0.05）。54例HP阳性的RAU患者中,抗HP治疗和常规治疗的RAU有效率分别为81.5%,51.9%（P〈0.05）。结论口腔中HP及消化性溃疡均与RAU的发病有某种相关。HP感染与RAU的发病率之间有一定关联,RAU患者较健康人群消化性溃疡患病率高,抗HP药物治疗更有利于RAU的愈合。