枸橼酸铋雷尼替丁三联疗法根除幽门螺杆菌

目的 :比较以枸橼酸铋雷尼替丁 (RBC)和以质子泵抑制药为主的短程三联疗法根除幽门螺杆菌 (Hp)的疗效和安全性 ,为根除Hp提供新的治疗方案。方法 :治疗组给予RBC 3 5 0mg ,克拉霉素 2 5 0mg ,甲硝唑 2 0 0mg ;对照组给予奥美拉唑 10mg ,克拉霉素 2 5 0mg ,甲硝唑 2 0 0mg ;两组各药均为每日 2次 ,po ,共 7d。结果 :按意向性治疗和实验方案分析 ,两组之间Hp根除率比较 ,差异无显著性 (P >0 .0 5 ) ;两组疼痛缓解率差异无显著性 (P >0 .0 5 )。结论 :以RBC为主的三联 1周方案Hp根除率与以奥美拉唑为主的三联 1周方案比较差异无显著性 ,但具有疗效高、价格低等优点。     

枸橼酸铋雷尼替丁的临床应用进展

枸橼酸铋雷尼替丁（RBC）是被众多国家批准的治疗消化性溃疡和根除幽门螺杆菌（Hp)的新化合物。RBC具有抑制胃酸分泌、粘膜保护、根除Hp、抑制胃蛋白酶活性以及与抗菌药的协同作用，其与抗菌药联合使用根除Hp受耐药的影响小，并具有药物经济学价值，是目前国际消化界普遍推荐的根除Hp一线用药方案之一。     

克拉霉素联合雷尼替丁治疗消化性溃疡幽门螺杆菌阳性的疗效观察

目的：观察克拉霉素与雷尼替丁铋盐联合应用治疗消化性溃疡幽门螺杆菌阳性患者的临床效果。方法选择2012年2月-2014年9月幽门螺杆菌阳性的消化性溃疡患者70例,随机分为观察组和对照组各35例,观察组使用克拉霉素联合雷尼替丁铋盐治疗,对照组仅单纯克拉霉素治疗。分析治疗后患者幽门螺杆菌的根除率、疗效及复发率。结果观察组的总有效率、幽门螺杆菌根除率及复发率均低于对照组,观察组患者腹痛、嗳气、腹胀缓解时间均短于对照组,差异均具有统计学意义（P ﹤0.05）。结论克拉霉素联合雷尼替丁铋盐治疗方法对消化性溃疡患者的幽门螺杆菌根除率高,可提倡应用于临床。     

枸橼酸铋雷尼替丁三联与兰索拉唑三联及四联疗法根除幽门螺杆菌的研究

目的:观察枸橼酸铋雷尼替丁(RBC)三联疗法对根除幽门螺杆菌(Helicobacter pylori,Hp)的效果,并通过与兰索拉唑三联或四联疗法对照研究以评价不同方案的疗效及其安全性.方法:93例经胃镜证实的Hp阳性伴有明显异常的慢性胃炎患者,随机分成RBC三联组(A组,RBC 350mg 阿莫西林1g 甲硝唑400mg,bid,疗程1周)、兰索拉唑三联组(B组,兰索拉唑30mg 阿莫西林1g 甲硝唑400mg,bid,疗程1周)和兰索拉唑四联组(C组,兰索拉唑30mg 阿莫西林1g 甲硝唑400mg 枸橼酸铋钾220mg,bid,疗程1周).疗程结束4周后复查Hp感染情况,观察Hp根除率、症状缓解率及不良反应等.结果:A,B和C三组Hp根除率分别为85%,84%和90%;3组疼痛缓解率分别为86%,83%和91%.组间比较均无统计学意义(P>0.05).结论:RBC为主的三联疗法的Hp根除率与以兰索拉唑为主的三联及四联疗法相当,不良反应发生相似.     

抗溃疡病新药——雷尼替丁枸橼酸铋

雷尼替丁枸橼酸铋是近年来问世的抗溃疡病新药。本文复习有关文献对该药的生化特性、药理作用、药物动力学及临床应用等,认为雷尼替丁枸橼酸铋与克拉霉素联合应用在愈合消化性溃疡、根除幽门螺杆菌及降低溃疡复发率等方面均有较好效果,是一种有效的抗溃疡药物。     

雷尼替丁枸橼酸铋联用克拉霉素治疗十二指肠溃疡的临床疗效

目的 观察雷尼替丁枸橼酸铋联用克拉霉素治疗治疗十二指肠溃疡的疗效.方法 选择128例活动性十二指肠溃疡患者,随机分治疗组64例与对照组64例进行比较.结果 治疗4周后治疗组总有效率为92.76%,优于对照组80.3%,差异有显著性意义(P＜0.05).结论 雷尼替丁枸橼酸铋联用克拉霉素治疗十二指肠溃疡的疗效好,副作用小.     

以枸橼酸铋雷尼替丁为基础的三联疗法根除

［摘要］　目的：应用枸橼酸铋雷尼替丁（RBC）或埃索美拉唑（EMO）分别与克拉霉素（C）+阿莫西林（A）三联7天疗法根除HP，评估以RBC为基础的三联方案的疗效。方法：40例功能性消化不良患者随机分配至A组或B组，每组20例，A组为RBC 0.2 g+C 0.5 g+A 1 g,bid,口服；B组为EMO 20 mg+C 0.5 g+A 1 g,bid,口服，疗程7 d。停药28 d后检查13C尿素呼气试验，如阴性表示根除成功，观察两组HP阴转率。结果：两组HP阴转率分别为85%和80%，差异无显著性（P>0.05）。患者依从性好，均未见严重不良反应。结论：RBC或EMO三联疗法根除HP，其HP阴转率A组略高于B组，RBC三联疗法根除HP疗效好。     

雷尼替丁胶体果胶铋治疗幽门螺杆菌感染

当前临床上根治幽门螺杆菌 (HP)的方案主要有二大类 ,一类是以铋制剂 (多为三钾二枸橼酸铋 )为主 ,再加二种抗生素的三联疗法 ,另一类是以抑酸药 (多为H2 受体阻滞剂 ,如雷尼替丁 )为主 ,再加二种抗生素的三联疗法。铋制剂与抑酸药合用者较少 ,可能是因高PH影响三钾二枸橼酸铋等制剂的疗效。胶体果胶铋胶囊的疗效不受PH高低的影响 ,为两者联合应用提供了可能 ,用抑酸剂与铋制剂联合应用的四联疗法 ,与以抑酸剂为主的三联疗法、以铋制剂为主的三联疗法作比较 ,观察其根除HP的疗效及症状改善程度和副作用发生率。1　对象与方法1 1　对象　…     

枸橼酸铋雷尼替丁为基础治疗萎缩性胃炎患者Hp的疗效观察

目的应用枸橼酸铋雷尼替丁(RBC)与克拉霉素+阿莫西林三联7d疗法根除幽门螺杆菌(Hp),评估以RBC为基础的三联方案的疗效。方法萎缩性胃炎120例随机分为R组和O组,每组60例,R组为RBC 350 mg+克拉霉素0.5 g+阿莫西林1 g,2次/d,口服;O组为奥美拉唑(OME)20 mg+克拉霉素0.5 g+阿莫西林1 g,2次/d,口服,疗程均为7 d。停药28 d后检查14C尿素呼气试验,如阴性表示根除成功,观察两组Hp阴转率。结果两组Hp阴转率分别为83.02%和71.15%,差异无统计学意义(P>0.05)。结论 R组根除萎缩性胃炎患者Hp感染,其Hp阴转率与O组相当。     

枸橼酸铋钾、克拉霉素和替硝唑治疗慢性胃炎的胃窦粘膜病理学改变

目的 :观察枸橼酸铋钾、克拉霉素和替硝唑三联治疗幽门螺杆菌相关性胃炎胃窦粘膜组织病理学改变。方法 :38例幽门螺杆菌 (Hp)感染的慢性胃炎病人按就诊前后入选 ,分为 2组 ,枸橼酸铋钾三联 (BCT)组和奥美拉唑三联 (OCT)组 ,分别给予口服枸橼酸铋钾 +克拉霉素 +替硝唑和奥美拉唑 +克拉霉素 +替硝唑 ,治疗 1wk。 4wk后检查13 C 尿素呼气试验 ,8mo后复查胃镜和胃粘膜活检。结果 :BCT组Hp根除率为 80 % ,OCT组为 83% ,2组间差异无显著意义 (P >0 .0 5 )。 2组病人治疗后胃粘膜组织慢性炎症、活动性炎症明显减轻 (P <0 .0 5 ) ,粘膜萎缩及肠化生程度无明显变化 (P >0 .0 5 )。BCT组与OCT组间病理学改变差异无显著意义 (P >0 .0 5 )。结论 :幽门螺杆菌感染与胃粘膜炎症反应有关 ,BCT具有较高的幽门螺杆菌根除率 ,并可减轻胃粘膜的炎症反应     

Ranitidine bismuth citrate and clarithromycin twice daily in the eradication of Helicobacter pylori

Background : Ranitidine bismuth citrate (RBC) 400 mg when given twice daily (b.d.) for 4 weeks with clarithromycin 250 mg four times daily (q.d.s.) for the first 2 weeks effectively heals duodenal ulcers and eradicates Helicobacter pylori .
Aims : To compare two dosage regimens of clarithromycin, 250 mg q.d.s. and 500 mg b.d., used with ranitidine bismuth citrate (Pylorid) 400 mg b.d., for the eradication of H. pylori and for symptom relief in patients with active duodenal ulcers.
Subjects : 236 patients with active duodenal ulcer and confirmed H. pylori infection.
Methods : In a randomized, double-blind, parallel group, multi-centre study, RBC was given with clarithromycin for 2 weeks followed by 2 weeks treatment with RBC alone to allow for ulcer healing. Ulcer status was assessed by endoscopy at entry. H. pylori status was assessed by CLO Test and ¹³C-urea breath test (UBT) at entry and UBT alone 4 weeks after the end of treatment. At entry, during the study and at follow-up, ulcer symptoms were recorded on a scale of none, mild, moderate or severe.
Results : 176 patients had an evaluable UBT at least 4 weeks post-treatment. H. pylori eradication rates were 96.2% for the RBC plus clarithromycin b.d. regimen and 91.8% for the RBC plus clarithromycin q.d.s. regimen (observed data). Four weeks post-treatment, 92% of patients receiving RBC b.d. plus clarithromycin q.d.s. and 89% receiving RBC b.d. plus clarithromycin b.d. were considered symptom successes (none or mild symptoms).
Conclusions : RBC 400 mg b.d. plus clarithromycin 500 mg b.d. was as effective as RBC 400 mg b.d. plus clarithromycin 250 mg q.d.s. in eradicating H. pylori and both regimens were well tolerated. The simpler dual therapy in a b.d. regimen might well encourage greater patient compliance.     

Alternative and rescue treatment regimens for Helicobacter pylori eradication

Eradication therapy has been incorporated into clinical practice. The regimens currently recommended for first-line treatment include a 2-week bismuth-based triple therapy (mainly in developing countries), a 1 – 2 week proton pump inhibitor (PPI)-based triple therapy and a 1-week ranitidine bismuth citrate (RBC)-based triple therapy. However, these regimens fail to eradicate Helicobacter pylori in up to 20% of patients due to poor compliance, inadequate treatment duration, smoking, old age and bacterial resistance to nitroimidazoles and/or macrolides in particular. Therefore, alternative regimens that avoid nitroimidazoles and/or macrolides or overcome bacterial resistance to these drugs, improve compliance, minimise side effects and/or reduce costs have been evaluated. One-week quadruple therapy, which adds a PPI or histamine receptor 2-blocker to bismuth-based triple therapy, usually achieves an eradication rate of 90% when used as an alternative first-line therapy but the efficacy decreases when used as a rescue therapy. Several new triple therapies that may be used as alternative and/or rescue therapies have been evaluated. Among these are furazolidone-based (furazolidone plus an antibiotic and a bismuth salt, a PPI or RBC), fluoroquinolone-based (levofloxacin or moxifloxacin plus an antibiotic and a PPI) and ecabet sodium-based (ecabet plus two antibiotics) triple therapies. Recently, rifabutin has been used in combination with a PPI and amoxycillin as a rescue therapy, with satisfactory eradication rates. In addition, a number of new antimicrobial agents are currently under investigation in in vitro studies but the clinical values of these agents needs to be confirmed.     

Ranitidine bismuth citrate with clarithromycin alone or with metronidazole for the eradication of Helicobacter pylori

BACKGROUND: Both triple therapy with ranitidine bismuth citrate (RBC) plus two antibiotics for 7 days and dual therapy of RBC with clarithromycin for 14 days have been extensively studied; both regimens effectively eradicate Helicobacter pylori. However, few studies have assessed the efficacy of dual therapy given for 7 days. AIM: To compare the efficacy and safety of RBC 400 mg with clarithromycin 500 mg, alone or with metronidazole 400 mg, given twice daily for 7 days for the eradication of H. pylori. METHODS: This single centre, randomized, double-blind study involved 118 patients with dyspepsia or a history of peptic ulcer disease. H. pylori infection was detected initially by CLO test, and confirmed in 109 patients by urea breath test and/or microbiology culture. H. pylori eradication was assessed 4 and 12 weeks after the end of treatment by urea breath test. H. pylori antibiotic susceptibility was assessed pre-study in all patients, and post-treatment in patients with a positive post-treatment urea breath test. Adverse events were recorded throughout the study. RESULTS: H. pylori was eradicated in 93% of patients who received RBC with clarithromycin and metronidazole and in 84% of patients who received RBC with clarithromycin (intention-to-treat rates). Per protocol eradication rates were 98% and 90% for triple therapy and dual therapy, respectively. The eradication of metronidazole-resistant H. pylori was achieved in 100% and 88% of patients following dual therapy and triple therapy, respectively, and acquired resistance to clarithromycin occurred in only one patient following treatment failure. Both treatments were well-tolerated; only one patient (2%) was withdrawn from each treatment group due to adverse events. CONCLUSIONS: RBC with clarithromycin and metronidazole is a highly effective and well-tolerated triple therapy regimen for the eradication of H. pylori. RBC with clarithromycin dual therapy has a similar efficacy, and offers an alternative to triple therapy when there are concerns about treatment with metronidazole or the use of multiple antibiotics. Both regimens are effective against antibiotic-resistant strains of H. pylori.     

枸橼酸铋钾、克拉霉素和替硝唑治疗消化性溃疡的药物经济学评价

目的 :比较 4个不同三联药物治疗消化性溃疡方案的成本效果分析。方法 :3 1 1例消化性溃疡病人 ,分 5组 ,运用药物经济学的最小成本法、成本效果分析法进行推算每例诊疗成本和评价。结果 :(1 )A ,B ,C ,D 4种三联治疗方案的幽门螺杆菌(Hp)根除率分别为 84% ,88% ,87% ,80 % ,各组间疗效相比P >0 .0 5 ;(2 )门诊诊疗总成本分别为5 86元 ,81 7元 ,648.2 7元 ,889.5 0元 ;(3 )应用枸橼酸铋钾 +克拉霉素 +替硝唑 (BCT)三联治疗 1wk溃疡愈合 1例的药费 3 0 3 .95元 ;Hp根除 1例的药费 2 75 .0 0元 ;(4 )BCT三联包装比单独包装 3种药物 ,每例病例可节约药费 47.3 7元。结论 :4种方案的成本效果分析和边际成本分析表明BCT三联治疗 1wk的门诊诊疗成本最低 ,为根除Hp的优选方案。     

抗Hp类药物联合枸橼酸铋钾治疗胃炎的效果

目的：分析抗幽门螺杆菌（Hp）类药物联合其他药物治疗胃炎的效果。方法选择本院2011年10月~2013年12月收治的52例胃炎患者,按随机平行对照法分为治疗组与对照组,每组26例。对照组给予抗Hp类药物（阿莫西林、克拉霉素、奥美拉唑）治疗,治疗组在对照组的基础上采用枸橼酸铋钾。两组患者均服药2个疗程,比较其临床治疗效果。结果治疗后,两组的胃痛视觉模拟评分（VAS）和胃泌素水平较治疗前均有改善（P<0.05）,且治疗组改善情况优于对照组,两组差异有统计学意义（P<0.05）。治疗组的总有效率为96.15%,显著高于对照组的69.23%,差异有统计学意义（P<0.05）。两组患者在治疗过程中均未出现不良反应。结论抗HP类药物联合其他药物治疗胃炎具有显著的临床疗效,可以有效抑制并清除Hp,保护胃黏膜,值得临床应用。     

Ranitidine bismuth citrate, tetracycline, clarithromycin twice-a-day triple therapy for clarithromycin susceptible Helicobacter pylori infection

BACKGROUND: Although many combination therapies have been proposed, there is still interest in identifying simple, inexpensive, effective protocols that have high rates of success. AIM: To investigate the role of the new soluble form of bismuth, ranitidine bismuth citrate, in twice-a-day therapy for Helicobacter pylori infection. METHODS: Patients with histologically and culture proven H. pylori infection received ranitidine bismuth citrate 400 mg, tetracycline HCl 500 mg, and clarithromycin 500 mg, each b.d. for 14 days, followed by 300 mg ranitidine once a day for 4 additional weeks. Outcome was assessed 4 or more weeks after the end of antimicrobial therapy by repeat endoscopy with histology and culture (49 patients) or urea breath testing (14 patients). RESULTS: Sixty-three patients completed the therapy, 59 men and four women (average age 56.7 years; range 31-75 years). All patients had clarithromycin-susceptible strains prior to therapy. H. pylori infection was cured in 94% (95% CI: 85-98%). There was a therapy failure in one patient who took the medicine for only 1 day and stopped because of side-effects. Three of the isolates from treatment failures were available post-failure; two were clarithromycin-resistant and one was susceptible. Side-effects were severe in two patients (3%) and moderate in three (primarily diarrhoea). CONCLUSIONS: Twice-a-day ranitidine bismuth citrate, tetracycline, clarithromycin triple therapy was well tolerated and effective for the treatment of H. pylori infection in patients with clarithromycin-susceptible H. pylori.     

含雷贝拉唑与枸橼酸铋雷尼替丁的两种三联疗法治疗消化性溃疡的疗效比较

目的:比较含雷贝拉唑(RAZ)与枸橼酸铋雷尼替丁(RBC)的两种三联疗法治疗消化性溃疡的临床疗效。方法:将确诊为消化性溃疡的患者148例按随机数字表法均分为RAZ组和RBC组,分别给予RAZ/RBC+克拉霉素+甲硝唑的三联疗法治疗1周,之后两组患者均单服RAZ或RBC治疗3周,疗程共4周。治疗结束后比较两组患者的疗效、溃疡愈合率和幽门螺杆菌(Hp)根除情况,并观察治疗中的不良反应。结果:治疗结束后,RAZ组与RBC组患者的临床总有效率分别为88.7%、83.3%,Hp根除率分别为87.3%、93.1%,溃疡愈合率分别为85.9%、87.5%,两组比较差异均无统计学意义(P>0.05)。两组患者的不良反应均较轻,不影响治疗,可自行好转。结论:含RAZ与RBC的两种三联疗法治疗消化性溃疡的疗效相当,且安全性均较好。