根除幽门螺杆菌对功能性消化不良的影响

目的通过长期随访观察根除幽门螺杆菌(Helicobacterpylori,Hp)后功能性消化不良(FD)者的症状能否得到缓解,阐明Hp与FD的关系.方法60例Hp感染的FD患者参加本次研究.运用改良的Glasgow评分表对患者的症状进行评分(范围0～10分).所有病例随机分为三组抗Hp治疗.A组口服RBC(雷尼替丁枸橼酸铋)400mg、阿莫西林1g和呋喃唑酮100mg各每日2次.B组口服阿莫西林1g和呋喃唑酮100mg各每日2次.C组口服RBC400mg、克拉霉素250mg和甲硝唑400mg各每日2次.总疗程均为7d,治疗后随访2年.在治疗后第4周及随访2年后行13C-尿素呼气试验,并于随访末再次对症状评分.结果全部患者完成治疗.42例Hp得以根除,18例抗Hp治疗失败.2年后54例完成复查,6例失访.其中39例为Hp根除者(39/54).另15例为抗Hp治疗失败者,其中7例在2年中曾自行接受追加的抗Hp治疗后为阴性,8例仍Hp阳性.39例根除者中未发现复发病例.大部分的患者症状评分均有改善,但持续感染者评分高于根除者.在根除者中,平均症状评分从4.90减为2.38,差异有显著性(P＜0.05).而持续感染者从5.00减至3.00,差异无显著性(P＞0.05).结论通过长期随访,我们发现根除Hp可在较长时间内仍改善FD症状.     

抗幽门螺杆菌感染治疗功能性消化不良

幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,Ｈｐ）感染与消化性溃疡及胃癌的相关已得到公认,但其与功能性消化不良（ｆｕｎｃｔｉｏｎａｌｄｙｓｐｅｐｓｉａ,ＦＤ）的关系目前尚存在争议［１］,我们拟从抗Ｈｐ治疗对ＦＤ患者症状的改善,来探讨抗Ｈｐ感染在...     

四种短程三联疗法根除幽门螺杆菌149例疗效比较

20 0 0年5月至2 0 0 2年10月,我们采用4种三联疗法根除幽门螺杆菌(HP)方案治疗HP阳性胃炎或消化道溃疡患者14 9例,并观察比较其疗效。现报告如下。临床资料:本文HP阳性胃炎、消化性溃疡患者14 9例,男96例,女5 3例;年龄36～5 5岁。1周内均未服用受试药品及非甾体抗炎药或皮质激素;无严重肝肾功能损害。将14 9例随机分为A、B、C、D四组,各组人数分别为35、38、37、39例,四组性别、年龄、病情、病程无显著差异。A组口服胶体果胶铋2 0 0 mg+甲硝唑4 0 0 m g+克拉雷素5 0 0 mg,1日2次;B组口服胶体果胶铋2 0 0 mg+替硝唑5 0 0 mg+克拉霉素5 0…     

幽门螺杆菌感染与功能性消化不良

功能性消化不良(FD)是指有消化不良症状,但经检查排除了引起这些症状的器质性疾病,并在过去12个月中症状至少存在12周的症征。FD根据主要症状又可分为以疼痛为主的溃疡样(ulcer like)型、以上腹饱胀不适为主的动力障碍样(dysmotility like)型以及难以归入上述二型的非特异(unsp     

功能性消化不良与幽门螺杆菌感染关系的探讨

功能性消化不良(Functional dyspepsid,FD)是一种常见病症,其病因与发病机理迄今尚未完全明了,幽门螺杆菌(Helicobacten pyloril,HP)的发现,无疑使这一问题更为复杂化。本文作者应用具有快速、可靠,有高度敏感的检测方法:聚合酶链反应(Polymerase chain reaction,PCR)检测336例FD患者唾液中的HP以探讨FD患者HP感染情况。     

幽门螺杆菌感染根除治疗在功能性消化不良的临床研究

幽门螺杆菌(Hp)感染在活动性胃炎、消化性溃疡、胃癌中发生发展关系密切，而功能性消化不良(FD)发病率较高，而且常伴Hp感染，为探讨Hp在FD中的作用，我们将伴Hp感染的FD作根除治疗，并与胃肠道动力促进剂西沙必利作对照，结果表明根除Hp治疗在FD中症状缓解率差，副作用多，现将研究结果报导如下。     

四种短程三联疗法根除幽门螺杆菌的随机对照临床研究

目前,根除幽门螺杆菌（Ｈｐ）是治疗消化性溃疡及慢性胃窦炎的主要措施之一。以质子泵抑制剂（ＰＰｌｓ）为基础的短程三联疗法是近几年来国外最常用的Ｈｐ根除方案［１］,但国内仅有少量文献报道［２］。我们以ＰＰｌｓ为基础,采用不同的药物及剂量搭配,构成４种短程...     

幽门螺杆菌与功能性消化不良

消化不良是指持续或反复发作的上腹痛或不适 ,包括不同程度和性质的上腹痛、上腹胀、早饱、嗳气、恶心等上腹部症状 ,病程超过 2周。功能性消化不良 (ＦＤ)是指有消化不良而经详尽的检查未能发现引起这些症状的局部或全身器质性病变[1] 。ＦＤ的病因及发病机制未明 ,目前认为是多种因素引起的临床综合征。自幽门螺杆菌 (Ｈｐ)发现以来 ,Ｈｐ与ＦＤ的关系便受到关注 ,因为ＦＤ患者中有30 %～ 6 0 %有Ｈｐ感染及由此而引起的慢性活动性胃炎。然而 ,十多年来大量的研究却一直未能为两者的关系提供明确的证据 :(1)不少调查表明 ,在ＦＤ患者中Ｈ…     

短程三联疗法根除幽门螺杆菌的多中心临床研究

近年幽门螺杆菌（Ｈ．ｐｙｌｏｒｉ）菌株的耐药性总是日益突出,寻找有效且无耐药性的抗生素及联合治疗方案是当前十分重要的课题。本文旨在评价以奥美拉唑（Ｏ,２０ ｍｇ）或胶体次枸橼酸铋（Ｂ,２４０ ｍｇ）为基础的含呋喃唑酮（Ｆ,１００ ｍｇ）或甲唑（Ｍ,４００ ｍｇ）同时加用羟氨苄青霉素（Ａ,１ ０００ ｍｇ）或克拉霉素（Ｃ,２５０ ｍｇ）的４种短程（１周）三联疗法的Ｈ．ｐｙｌｏｒｉ根除率。方法：采用由     

Symptom-based tendencies of Helicobacter pylori eradication in patients with functional dyspepsia

AIM： To investigate whether there were symptom-based tendencies in the Helicobacter pylori （H. pylori） eradication in functional dyspepsia （FD） patients. METHODS： A randomized, single-blind, placebo-controlled study of H. pylori eradication for FD was conduct- ed. A total of 195 FD patients with H. pylori infection were divided into two groups： 98 patients in the treatment group were treated with rabeprazole 10 mg twice daily for 2 wk, amoxicillin 1.0 g and clarithromycin 0.5 g twice daily for 1 wk; 97 patients in the placebo group were given placebos as control. Symptoms of FD, such as postprandial fullness, early satiety, nausea, belching,epigastric pain and epigastric burning, were assessed 3 mo after H. pylori eradication. RESULTS： By per-protocol analysis in patients with successful H. pylori eradication, higher effective rates of 77.2% and 82% were achieved in the patients with epigastric pain and epigastric burning than those in the placebo group （P 〈 0.05）. The effective rates for postprandial fullness, early satiety, nausea and belching were 46%, 36%, 52.5% and 33.3%, respectively, and there was no significant difference from the placebo group （39.3%, 27.1%, 39.1% and 31.4%） （P 〉 0.05）. In 84 patients who received H. pylori eradication therapy, the effective rates for epigastric pain （73.8%） and epigastric burning （80.7%） were higher than those in the placebo group （P 〈 0.05）. The effective rates for postprandial fullness, early satiety, nausea and belch- ing were 41.4%, 33.3%, 50% and 31.4%, respective- ly, and did not differ from those in the placebo group （P 〉 0.05）. By intention-to-treat analysis, patients with epigastric pain and epigastric burning in the treatment group achieved higher effective rates of 60.8% and 65.7% than the placebo group （33.3% and 31.8%） （P 〈 0.05）. The effective rates for postprandial fullness, early satiety, nausea and belching were 34.8%, 27.9%, 41.1% and 26.7% respectively in the treatment group, with no significant difference from those in the placebo group （34.8%, 23.9%, 35.3% and 27.1%） （P 〉 0.05）. CONCLUSION： The efficacy of H. pylori eradication has symptom-based tendencies in FD patients. It may be effective in the subgroup of FD patients with epigastric pain syndrome.     

Azithromycin-containing versus standard triple therapy for Helicobacterpylori eradication： A meta-analysis

AIM: To evaluate whether adding azithromycin to firstline Helicobacter pylori (H pylori ) eradication improved eradication and reduced side effects. METHODS: Eligible articles were identified by searches of electronic databases. We included all randomized trials that compared azithromycin-containing with standard triple-therapy regimens for first-line treatment of H pylori infection. Statistical analysis was performed with Review Manager 5.0.10. Sub-analyses were also performed.RESULTS: We identified 14 randomized trials (1431 patients). Pooled H pylori eradication rates were 72.01% (95% CI: 58.09%-85.93%) and 69.78% (95% CI: 66.47%-73.09%) for patients with or without azithromycin by intention-to-treat analysis, and the odds ratio (OR) was 1.17 (95% CI: 0.64-2.14). The occurrence of side effects differed significantly and was 15.81% (95% CI: 12.50%-19.12%) and 25.20% (95% CI: 21.44%-28.96%) for treatment with or without azithromycin, respectively, and the summary OR was 0.58 (95% CI: 0.41-0.82). Furthermore, the azithromycin-containing group had a lower occurrence of diarrhea, nausea and taste disturbance. CONCLUSION: Our review suggests that azithromycincontaining triple-therapy regimens could be equally effective in eradication of H pylori compared with standard first-line triple-therapy regimens.     

Role of Helicobacter pylori in functional dyspepsia

The aetiology of dyspepsia is unknown in the majority of patients. Helicobacter pylori (H pylori) is the cause in a subset of patients. A non invasive test to assess the presence of H pylori is recommended in the management of patients under the age of 50 presenting to a family practitioner with dyspepsia. A urea breath test or a stool antigen test are the most reliable non invasive tests. Eradication of H pylori will reduce the risk to the patient with dyspepsia of developing a peptic ulcer, reduce the complication rate if prescribed nonsteroid anti-inflammatory drugs and later reduce the risk of gastric cancer. The recommended treatment for non ulcer dyspepsia associated with a H pylori infection should be a 10-d course of treatment with a PPI and two antibiotics. Treatment efficacy should be assessed four weeks after completing treatment with a urea breath test or a stool antigen test.     

功能性消化不良与幽门螺杆菌关系的研究进展

功能性消化不良(FD)患者感染幽门螺杆菌(H.pylori)十分常见,H.pylori对于FD的发病过程有重要意义。本文旨在总结H.pylori在FD发病过程中的作用和根除H.pylori治疗对FD疾病进程影响的相关研究进展。     

低剂量三联疗法根除幽门螺杆菌的多中心临床研究

本研究对根除幽门螺杆菌（Ｈｐ）的三联疗法进行改良，减少其中阿莫西林及甲硝唑的剂量，对Ｈｐ阳性的１７３例慢性胃炎患者及２６７例十二指肠溃疡患者进行Ｈｐ根除治疗。用药方法为胶体次枸橼酸铋（德诺，ＣＢＳ）１２０ｍｇ，阿莫西林２５０ｍｇ，及甲硝唑２００ｍｇ同服，每日４次，连服１４天，Ｈｐ根除率为８６．８％。此外，对４９例慢性胃炎及１０７例十二指肠溃疡Ｈｐ阳性者减少服药次数，采用每日２次给药，连服１４天，Ｈｐ根除率８９．１％。研究证明，低剂量三联疗法Ｈｐ根除率高，不良反应少，有较好的依从性。每日２次服药与每日４次服药临床疗效相似，Ｈｐ根除率差异无显著性（Ｐ＞０．０５）。     

Efficacy of Helicobacter pylori eradication therapy for treatment of functional dyspepsia: A protocol for systematic review and meta-analysis

Objective:The effect of Helicobacter pylori (H pylori) eradication therapy in functional dyspepsia (FD) patients was inconsistent in previously published randomized controlled trials. Therefore, we performed a comprehensive protocol for systematic review and meta-analysis in order to assess whether H pylori eradication therapy benefits patients with FD.Methods:In this systematic review and meta-analysis, we will search Web of Science, Embase, PubMed, Wanfang Data, Medline, Science Direct, Cochrane Library through April, 2021. The protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Data extraction was performed independently and only randomized clinical trials were included in this study. The risk of bias assessment was performed using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions. All calculations were carried out with Stata 11.0 (The Cochrane Collaboration, Oxford, United Kingdom).Results:We hypothesized that H pylori eradication therapy compared to no eradication therapy has a statistically significant benefit for symptom relief and can also reduce the development of peptic ulcer disease.Conclusion:This study expects to provide credible and scientific evidence for the efficacy of H pylori eradication therapy for patients with FD.OSF registration number:10.17605/OSF.IO/4EHRB     

雷贝拉唑与奥美拉唑短程三联或四联疗法根除幽门螺杆菌的随机对照研究

目的　评估雷贝拉唑 (R)与奥美拉唑 (O)在含有克拉霉素 (C)和阿莫西林 (A)的短程三联或加用呋喃唑酮 (F)的超短程四联根除幽门螺杆菌 (Hp)方案中的疗效。 方法　将 180例Hp阳性、内镜检查确诊为消化性溃疡或非溃疡性消化不良的患者随机分为雷贝拉唑治疗组 (R组 )和奥美拉唑对照组 (O组 )。R组和O组又分别分为RAC 7天 /OAC 7天组、RAC 5天 /OAC 5天组和RACF 3天 /OACF 3天组 ,每天服药 2次 ,疗程分别为 7天、5天和 3天。各组患者在治疗前 1周内和治疗后 4～ 8周分别经内镜活组织学检查、快速尿素酶试验和1 3 C UBT检测Hp感染状况并评估溃疡合情况。结果　在Hp根除率方面 ,根据意图治疗分析 (ITT)和按试验方案 (PP)分析 ,R组总的Hp根除率均显著高于O组 (P <0 .0 5 ) ;RACF 3天的Hp根除率显著高于OACF 3天组 (P <0 .0 5 ) ,OACF 3天组的Hp根除率显著低于OAC 7天组 (P <0 .0 1)和OAC 5天组 (P <0 .0 5 ) ,RACF 3天组与RAC 7天组和RAC 5天组比较差异无显著性。各组间溃疡愈合率比较差异无显著性。结论　雷贝拉唑与阿莫西林、克拉霉素联合的短程三联或与阿莫西林、克拉霉素和呋喃唑酮联合的短程四联疗法具有良好的耐受性 ,其超短程四联 3天疗法的Hp根除率和溃疡愈合率均接近于三联 7天和 5天疗法 ,显著优于以     

复方嗜酸乳杆菌片在提高首次根治失败的幽门螺杆菌感染的再次根治率中的作用

目的观察复方嗜酸乳杆菌片联合三联疗法在提高首次根治失败的幽门螺杆菌(H.pylori)感染的再次根治率中的作用。方法选取2011年1月-2012年6月在江苏省江阴市人民医院门诊诊断H.pylori阳性的消化性溃疡(胃溃疡、十二指肠球部溃疡、复合溃疡)、慢性胃炎(非萎缩/萎缩)经过标准三联方案首次根治失败的患者共180例。按实验组∶对照组=1∶1设计随机表,按随机区组设计进行随机分组,按照病例入选先后顺序分配随机号,每组90例。实验组:复方嗜酸乳杆菌片1 g(2片)/次,3次/d,餐后使用,疗程14 d(d1~14),继续给予雷贝拉唑10 mg+阿莫西林1.0 g,2次/d,莫西沙星400 mg,1次/d,疗程10 d(d15~24);对照组:给予雷贝拉唑10 mg+阿莫西林1.0 g,2次/d,莫西沙星400 mg,1次/d,疗程10 d(d1~10)。治疗结束至少4周后所有患者经13C尿素呼气试验(13C-UBT)或胃镜行病理学检查检测H.pylori,并对治疗中抗生素不良反应发生情况进行比较。结果实验组及对照组的H.pylori根除率符合方案数据分析(PP)分别为:72.9%(62/85)、54.7%(47/86)(χ2=6.188,P=0.013),而意向性分析(ITT)分别为:68.9%(62/90)、52.2%(47/90)(χ2=5.233,P=0.022),两组相比,差异有统计学意义(P0.05)。对照组在治疗中恶心呕吐、腹泻、便秘、口腔异味等不良反应发生率明显高于实验组(P0.05)。结论复方嗜酸乳杆菌联合三联疗法对首次标准三联疗法根治失败的H.pylori感染患者,H.pylori根除率高于对照组,同时可以有效降低治疗过程中的不良反应。     

Effectiveness of minocycline-based triple therapy for eradication of Helicobacter pylori infection

Background: Widespread use of eradication therapy for Helicobacter pylori has increased the prevalence of clarithromycin‐resistant strains. The purpose of the present paper was to measure the in vitro antibacterial activity of minocycline against H. pylori, and study the effectiveness of minocycline‐based first‐ and second‐line eradication therapies. Methods: For first‐line therapy, 79 patients were randomly assigned to the treatment with rabeprazole, amoxicillin, and clarithromycin or with rabeprazole, amoxicillin, and minocycline. For second‐line therapy, 88 patients were tested for sensitivity to metronidazole: 67 patients with metronidazole‐sensitive strains received a 7‐day course of rabeprazole, minocycline, and metronidazole; the remaining 21 patients were given a 7‐day course of rabeprazole, minocycline, and faropenem. Results: There was virtually no resistance to minocycline among the strains tested. The eradication rate of H. pylori infection in first‐line therapy was significantly lower for minocycline‐containing regimen (38.5%, 15/39) than for clarithromycin‐containing regimen (82.5%, 33/40; P < 0.01). For second‐line therapy, a high eradication rate against metronidazole‐sensitive strains was obtained with rabeprazole, minocycline and metronidazole (85%, 57/67). Conclusions: A combination of rabeprazole, minocycline, and metronidazole is safe and effective for second‐line therapy of H. pylori infection. Because this regimen can be administered to patients with penicillin allergy and patients who suffer adverse reactions to amoxicillin, such as diarrhea and other digestive symptoms, it should be considered useful for second‐ and third‐line eradication therapy.     

序贯疗法和标准三联疗法根除幽门螺杆菌的疗效比较

目的:观察10d序贯疗法治疗幽门螺杆菌(Helicobacter pylori,H.pylori)的疗效及不良反应,与14d三联标准疗法比较H.pylori根除情况及经济学上有无优越性.方法:将103例经胃镜检查确诊为慢性胃炎或消化性溃疡且H.pylori阳性的患者随机分为两组,治疗组(10d序贯疗法)52例,前5d埃索美拉唑、阿莫西林,后5d埃索美拉唑、克拉霉素、替硝唑.对照组(14d标准三联疗法)51例,埃索美拉唑、阿莫西林、克拉霉素14d.所有患者停药4wk后复查13C呼气试验或胃镜检查,判断H.pylori根除情况.结果:治疗组H.pylori根除率为90.4%,与对照组(90.2%)比较无统计学差异(P=1.000);两组不良反应发生率分别为12/52(23.1%)、18/51(35.3%),两组比较无统计学差异(P=0.172);治疗组费用为380.6元,较对照组(677.88元)明显减低.结论:10d序贯疗法的H.pylori根除率不低于标准14d三联疗法,2组不良反应发生率相似,但10d序贯疗法根除H.pylori的效价比更高.