兰索拉唑治疗十二指肠溃疡疗效观察

１９９８年５月～１９９９年４月,我们应用兰索拉唑治疗十二指肠溃疡,并与奥美拉唑对照,报道如下。１资料与方法１１资料６３例经胃镜证实为活动期十二指肠溃疡患者,随机分成兰索拉唑组（Ａ组）３３例,男２０例,女１３例,年龄（４０．２±１２．３）岁,溃疡直径（０．６５±０．２９）ｃｍ。奥美拉唑对照组（Ｂ组）３０例,男１８例,女１２例,年龄（４０．５±１５．９）岁,溃疡直径（０．７０±０．３０）ｃｍ。两组情况具有可比性。１２治疗方法Ａ组服用兰索拉唑３０ｍｇ,每晨１次;Ｂ组服用奥美拉唑２０ｍｇ,每晨１次,疗程均为４ｗｋ。观察…     

兰索拉唑加阿莫西林治疗幽门螺杆菌相关的胃和十二指肠溃疡

目的：研究幽门螺杆菌（ＨＰ）相关的消化性溃疡。方法：１１０例ＨＰ阳性的溃疡病人,男性７８例,女性３２例,年龄５７ａ±ｓ８ａ（１８～８０ａ）,用兰索拉唑加阿莫西林二联疗法,兰索拉唑３０ｍｇ,每日晨、晚各服１次,阿莫西林５００ｍｇ,每日４次,连服２ｗｋ后,停用阿莫西林,改用兰索拉唑３０ｍｇ,每日晨服１次,维持治疗４ｗｋ。结果：ＨＰ清除率为８７．３％,溃疡愈合率９０．９％,总有效率９７．３％。结论：兰索拉唑加阿莫西林二联疗法是一种治疗幽门螺杆菌相关的胃和十二指肠溃疡的有效方法     

麦滋林-s加雷尼替丁治疗消化性溃疡

目的：观察麦滋林－ｓ加雷尼替丁治疗消化性溃疡的疗效。方法：经胃镜确诊的消化性溃疡８７例，随机分为治疗组（男性４０例，女性７例，年龄３８±ｓ１４ａ）餐前冲服麦滋林－ｓ０．６７ｇ，ｔｉｄ，加雷尼替丁胶囊１５０ｍｇ，ｂｉｄ；对照组（男性３７例，女性３例，年龄３８±１３ａ）单用雷尼替丁１５０ｍｇ，ｐｏ，ｂｉｄ。疗程均为４～６ｗｋ。结果：消化性溃疡治疗４ｗｋ和６ｗｋ的愈合率，治疗组是６２％和９６％，对照组是３０％和８５％，２组４ｗｋ和６ｗｋ的愈合率相比Ｐ＜０．０５和Ｐ＞０．０５。症状消失时间依次为８±３ｄ和１３±３ｄ，Ｐ＜０．０１。治疗后９～１２ｍｏ溃疡复发率依次为６％和１５％。结论：麦滋林－ｓ加雷尼替丁治疗消化性溃疡较单用雷尼替丁的效果好。     

兰索拉唑15mg与30mg治疗十二指肠溃疡效果及其安全性比较

为了比较兰索拉唑每日１５ｍｇ与３０ｍｇ两处剂量口服治疗十二指肠溃疡的效果及安全性,对１０９例经内镜证实活动性十二指肠溃疡随机分成１５ｍｇ组（５１例）和３０ｍｇ组（５８例）。剂量分别为每日１５ｍｇ和３０ｍｇ,疗程２￣４周。于疗程结束后重复胃镜检查,２周溃疡愈合率１５ｍｇ组为７０．６％;３０ｍｇ组为８９．７％,３０ｍｇ组明显高于１５ｍｇ组（Ｐ〈０．０５）。４周溃疡愈合率１５ｍｇ和３０ｍｇ组分别为９６．     

尼莫地平预防蛛网膜下腔出血的脑血管痉挛

目的：观察尼莫地平预防蛛网膜下腔出血（ＳＡＨ）后的脑血管痉挛（ＣＶＳ）。方法：ＳＡＨ病人１０７例，男性５５例，女性５２例，年龄５４±ｓ９ａ，随机分尼莫地平组（６７例）与对照组（４０例）。尼莫地平组中２９例于ｄ１～２用静脉滴注（静滴）２ｍｇ／ｄ，ｄ３起４ｍｇ／ｄ，７～１４ｄ以后口服尼莫地平３０ｍｇ／６ｈ，另３８例于ｄ１～１４用尼莫地平２ｍｇ／ｄ静滴，余同上，共４ｗｋ．对照组用一般的综合治疗４ｗｋ．结果：尼莫地平组死亡率为１５％，症状性ＣＶＳ发生率为３％，分别低于对照组３２％与２２％（Ｐ＜０．０５与Ｐ＜０．０１）。未发现副作用。结论：尼莫地平预防ＳＡＨ后的ＣＶＳ有效。     

兰索拉唑三联疗法根除幽门螺杆菌1周与2周疗效对比研究

目的 研究兰索拉唑三联疗法治疗幽门螺杆菌（Ｈｐ）相关性十二指肠溃疡疗效及安全性，比较１周疗法与２周疗法的Ｈｐ根除率，溃疡愈合率及疼痛缓解率。方法：４６例经胃镜证实的Ｈｐ阳性的十二指肠溃疡患者，随机分成１周疗法组（Ａ组）和２周疗法组（Ｂ组）Ａ线，Ｂ组两组用药物为兰索拉唑３０ｍｇ，ｂｉｄ，阿莫西林１．０ｇ，ｂｉｄ；甲硝唑０．４ｇ，ｂｉｄ，Ａ组抗生素（阿莫西林和甲硝唑）只用１周，Ｂ组周２周，兰索拉唑均用     

兰索拉唑联合克拉霉素、阿莫西林治疗幽门螺杆菌感染消化性溃疡

目的：观察兰索拉唑联合克拉霉素、阿莫西林根除幽门螺杆菌及对溃疡愈合的效果。方法：对经胃镜确诊为消化性溃疡的病人进行幽门螺杆菌检测,确认为阳性者４６例给予兰索拉唑３０ｍｇ每日１次口服,共２周;克拉霉素０２ｇ每日３次口服;阿莫西林０５ｇ每日３次口服,共４周,停药４周后复查胃镜及幽门螺杆菌检查。结果：胃溃疡愈合率７７８％;十二指肠溃疡愈合率９２８％;幽门螺杆菌根除率胃溃疡为８３３％,十二指肠溃疡为８８９％,副作用发生率为２１８％。结论：兰索拉唑联合克拉霉素、阿莫西林是安全有效的治疗幽门螺杆菌感染消化性溃疡的方案     

兰索拉唑口服治疗消化性溃疡急性大出血

目的：观察兰索拉唑口服治疗消化性溃疡急性大出血的疗效。方法：３０例消化性溃疡急性大出血病人（男性２４例，女性６例，年龄４８±ｓ１６ａ）予兰索拉唑３０ｍｇ，ｐｏ，ｑｄ×（１０～１４ｄ），并酌情输液、输血。结果：兰索拉唑３０例（１００％）止血成功，住院天数为１４．１±２．１ｄ；输血量为０。未见药物不良反应。结论：兰索拉唑口服对消化性溃疡急性大出血有良好疗效。     

整肠生治疗婴儿迁延性腹泻

婴儿迁延性腹泻６０例，随机分为２组。对照组３０例（男性１７例，女性１３例；年龄０．６±ｓ０．４ａ）以多酶片和复合维生素Ｂ治疗。整肠生组３０例（男性２１性，女性９例；年龄０．７±０．３ａ）给上述药物外，加用整肠生０．０７５ｇ／（ｋｇ．ｄ）分３次口服。２组疗程均为１ｗｋ。结果：整肠生治愈率８０％及平均止泻时间，３．４±２．４ｄ均优于对照组的４０％及４．３±２．１ｄ（Ｐ＜０．０１及０．０５）。     

兰索拉唑联合克拉霉素,阿莫西林治疗幽门螺杆菌感染消化性溃疡

目的;观察兰索拉唑联合克拉霉素,阿莫西林根除幽门螺杆菌及对溃疡愈合的效果。方法;对经胃镜确诊为消化性溃疡的病人进行幽门螺杆菌检测,确认为阳性者４６例给予兰索拉唑３０ｍｇ每日１次口服,共２周;克拉霉素０．２ｇ每日３次口服;阿莫西林０．５每日３次口服,共４周,停药４周后复查胃镜及幽门螺杆菌检查。     

Short-term triple therapy with lansoprazole 30 mg or 60 mg, amoxycillin and clarithromycin to eradicate Helicobacter pylori

BACKGROUND: We investigated the efficacy of 30 vs. 60 mg lansoprazole daily in a 1-week triple therapy for eradication of Helicobacter pylori in a prospective randomized study. METHODS: Two hundred and fifteen consecutive out-patients with peptic ulcer disease or non-ulcer dyspepsia, in whom H. pylori infection was confirmed by histology and/or a urease biopsy test, were randomly assigned to a 1-week treatment with either 15 mg lansoprazole b.d. (LAC15 group) or 30 mg lansoprazole b.d. (LAC30 group) in combination with 1 g amoxycillin b.d. and 500 mg clarithromycin b.d. RESULTS: Eradication of H. pylori was successful in 87% (per protocol) and 82% (intention-to-treat) of the patients with LAC15 and in 94% (per protocol) and 87% (intention-to-treat) of the patients with LAC30. The difference was not significant. In both treatment groups, all peptic ulcers were healed at the check-up. Adverse effects were seen in 11 patients of the LAC15 group and 10 patients of the LAC30 group: they caused discontinuation of the therapy in four of the LAC15 group and two patients of the LAC 30 group. CONCLUSIONS: A 7-day triple therapy using lansoprazole (LAC15) is an efficient and economical regimen for the eradication of H. pylori.     

A comparison of three doses of lansoprazole (15, 30 and 60 mg) and placebo in the treatment of duodenal ulcer

Background: Lansoprazole is a new proton pump inhibitor for the treatment of peptic ulcer disease. Methods: A double-blind, multicentre study was undertaken in 2 9 6 patients with endoscopically proven duodenal ulcer to compare the efficacy and safety of lansoprazole 15, 30 or 60 mg with placebo. Ulcer healing was documented by endoscopy at 2 and 4 weeks; patients whose ulcers healed after 4 weeks were followed for up to 6 months post-treatment. Results: Four-week healing rates of 89.4% 91.7% and 89.9% were obtained with lansoprazole 15, 30 and 60 mg, respectively, compared with 46.1 % on placebo (P < 0.001). All three doses of lansoprazole produced rapid symptom relief, although patients taking 60 mg lansoprazole required fewer antacids than did those taking 15 mg. At 6 months, the percentages of patients healed were 45.3%, 40.0% and 38.4% in the lansoprazole 15, 30 and 60 mg dosage groups, respectively, and 2 5.3 % for the placebo group. No significant adverse events were documented during the period of this trial. Conclusion: Lansoprazole is an effective and safe treatment for duodenal ulcer and the 15 mg dose is as effective as 30 or 60 mg.     

兰索拉唑与奥美拉唑治疗消化性溃疡的比较

目的 :观察兰索拉唑对消化性溃疡的疗效并与奥美拉唑进行比较。方法 :64例经内镜确诊的消化性溃疡病人分为 2组。兰索拉唑组 36例 (男性2 8例 ,女性 8例 ,年龄 4 1±s 8a)用兰索拉唑 30mg ,po ,qm× 4wk ;奥美拉唑组 2 8例 (男性 2 2例 ,女性 6例 ,年龄 4 2± 10a)以奥美拉唑 2 0mg ,po ,qm× 4wk。结果 :2组在溃疡愈合率 ( 89%vs90 % )、总有效率 ( 94 %vs 93% )和d 7腹痛缓解率( 97%vs 96% )均无显著差异 (P均 >0 .0 5)。但d 3腹痛缓解率兰索拉唑组显著高于奥美拉唑组 ( 83%vs 71% ,P <0 .0 5)。 2组不良反应均轻微。结论 :兰索拉唑对消化性溃疡有良好疗效     

雷贝拉唑治疗消化性溃疡及清除幽门螺杆菌感染的近期疗效

目的 :观察雷贝拉唑治疗消化性溃疡的临床疗效及对幽门螺杆菌 (Hp)感染的清除率。方法 :116例消化性溃疡病人 ,其中雷贝拉唑组 4 6例 ,给雷贝拉唑 10mg ,po ,bid(或 qd) ;奥美拉唑组 70例 ,给奥美拉唑 2 0mg ,po ,bid(或 qd)。若Hp(+ ) ,同时给予杀菌治疗 1wk。观察治疗前后症状积分的变化 ,疗程结束时 ,复查胃镜观察溃疡的愈合情况。结果 :雷贝拉唑组治疗 4 (6 )wk后主要临床症状积分为 (18.4± 1.3)分 ,与治疗前 (74± 6 )分相比 ,P <0 .0 1,与奥美拉唑组相比 ,P >0 .0 5 ;溃疡的愈合率96 % ,与奥美拉唑组相比 ,P <0 .0 1。Hp清除率雷贝拉唑组为 93% ,奥美拉唑组为 89% ,P >0 .0 5。结论 :雷贝拉唑能明显缓解消化性溃疡症状 ,止痛效果快 ,对溃疡有较高的愈合率及Hp清除率。     

兰索拉唑在消化性溃疡病人中的药代动力学研究

目的在消化性溃疡病人中观察兰索拉唑的药代动力学的变化，进一步了解该药的代谢规律。方法选取经胃镜检查确诊为消化性溃疡的患者为试验组（Ｇ组，ｎ＝６）及健康志愿者为对照组（Ｃ组，ｎ＝６），口服兰索拉唑胶囊３０ｍｇ，定时取血通过高压液相方法测定血药浓度。利用３Ｐ８７药代动力学程序模拟药时曲线，计算药代动力学参数。结果兰索拉唑符合一房室模型。试验组中，５位患者的吸收速率常数Ｋα较对照组的Ｋα明显增加，吸收半衰期Ｔ１２α及达峰时间Ｔｍａｘ明显减少。血药浓度高峰Ｃｍａｘ有明显提高。而清除速率常数Ｋβ、清除半衰期Ｔ１２β也有较明显的差别，其表观分布容积Ｖ／Ｆ、清除率ＣＬ／Ｆ及血药浓度曲线下面积ＡＵＣ差别均不显著。１位幽门不全梗阻患者的药代动力学曲线表明吸收明显延迟。结论兰索拉唑口服后，分布广泛，代谢迅速。消化性溃疡患者应用时，其吸收速率和其排泄明显加快。血药浓度高峰明显增加，对于治疗该病可能具有重要的意义。     

Lansoprazole is superior to ranitidine as maintenance treatment for the prevention of duodenal ulcer relapse

AIM: To compare lansoprazole 30 mg once daily, lansoprazole 15 mg once daily and ranitidine 150 mg once nightly in the prevention of duodenal ulcer relapse in patients whose duodenal ulcers had been previously healed with lansoprazole 30 mg once daily or ranitidine 300 mg nightly. METHODS: A double-blind, parallel group, randomized multicentre study conducted in 33 centres in the UK, Eire, Sweden and Australia. Two hundred and nineteen patients with a duodenal ulcer were randomized to receive lansoprazole 30 mg and 217 to receive ranitidine 300 mg for 8 weeks. Patients were then re-randomized to receive lansoprazole 30 mg (122 patients), lansoprazole 15 mg (121 patients) or ranitidine 150 mg (116 patients) for 12 months. All patients had an endoscopically-proven duodenal ulcer at baseline and were considered suitable for long-term maintenance therapy to prevent relapse. RESULTS: Significantly more patients were healed on lansoprazole (98%) compared to ranitidine (89%) (P < 0.001, Fisher's exact test). Lansoprazole provided more rapid symptom relief than ranitidine. Lansoprazole 30 mg and lansoprazole 15 mg increased the probability of not relapsing in comparison to ranitidine (P = 0.001 and 0.06, respectively, life-table analysis). Relapse rates over the 12 months were lower in the lansoprazole treatment groups (lansoprazole 30 mg, 5%; lansoprazole 15 mg, 12%; and ranitidine, 21%; lansoprazole 30 mg vs. ranitidine 150 mg, P = 0.002). Symptoms were well controlled in both groups during the maintenance phase. All treatments were well tolerated with no major differences seen in adverse event profiles between treatment groups. CONCLUSIONS: Both doses of lansoprazole (30 mg and 15 mg) were superior to ranitidine 150 mg in the prevention of duodenal ulcer relapse. Lansoprazole was superior to ranitidine in terms of symptom control and duodenal ulcer healing. Both treatments were well tolerated.     

Effects of lansoprazole plus amoxycillin on the cure of Helicobacter pylori infection in Japanese peptic ulcer patients

Aim : The effect of lansoprazole plus amoxycillin on curing Helicobacter pylori infection and peptic ulcer recurrence was evaluated.
Method : The study group was composed of 68 patients with gastric ulcers and 51 with duodenal ulcers, all were H. pylori -positive. The participants were assigned at random to the lansoprazole alone group (lansoprazole 30 mg o.m. for 6 or 8 weeks) or the lansoprazole plus amoxycillin group (lansoprazole alone regimen plus amoxycillin at 500 mg q.d.s. concomitantly for the first 2 weeks). Healed patients were not given maintenance treatment with acid secretion inhibitors. The cure rate for H. pylori infection and the ulcer recurrence rate after 1 year were investigated.
Result : The cure rate for H. pylori infection was 4.2% in patients receiving lansoprazole alone and 38.5% in patients receiving lansoprazole plus amoxycillin ( P < 0.01) for gastric ulcers, and 0% in patients receiving lansoprazole alone and 61.9% in patients receiving lansoprazole plus amoxycillin ( P <0.001) for duodenal ulcers. The recurrence rate was 42.3% in patients receiving lansoprazole alone and 28.6% in patients receiving lansoprazole plus amoxycillin for gastric ulcers, and 66.7% for patients receiving lansoprazole alone and 11.1% for patients receiving lansoprazole plus amoxycillin ( P <0.001) for duodenal ulcers. None of the patients with gastric or duodenal ulcers cured of H. pylori infection had a recurrence.
Conclusion : Concomitant use of lansoprazole and amoxycillin increased the curative effects on H. pylori infection. However, the cure rates with this regimen remained inadequate.     

蒙脱石治疗消化性溃疡50例

目的 :评价蒙脱石治疗消化性溃疡的临床疗效与安全性。方法 :蒙脱石组 (5 0例 )患胃溃疡 18例和十二指肠球部溃疡 32例 [男性 35例 ,女性 15例 ,年龄 (5 0±s 11)a],用蒙脱石散剂 3g ,tid ,疗程 4wk。胶态次枸橼酸铋组 (30例 )患胃溃疡 12例和十二指肠球部溃疡 18例 [男性 2 0例 ,女性 10例 ,年龄(48± 13)a],用胶态次枸橼酸铋胶囊 110mg ,tid ,疗程 4wk。结果 :蒙脱石组消化性溃疡愈合率为80 % ,总有效率为 90 % ,胶态次枸橼酸铋组消化性溃疡愈合率为 6 0 % ,总有效率为 77% ;2组愈合率、总有效率相比 ,差异无显著意义 (P >0 .0 5 ) ,2组疗效的比较差异亦无显著意义 (P >0 .0 5 )。 2组不良反应均轻 ,分别为 4 %和 3% (P >0 .0 5 )。结论 :蒙脱石治疗消化性溃疡有较好疗效 ,且不良反应少而轻微 ,是一种安全有效的药物