健肝愈胃汤合西药治疗门脉高压性胃病临床观察

目的探讨中药健肝愈胃汤（自拟）、西药心得安、奥美拉唑、胶态果胶铋胶囊联合治疗门脉高性胃病（PHG）的疗法。方法将136例PHG患者随机分成两组,对照组52例常规口服心得安、奥美拉唑、果胶铋;治疗组84例在常规服用以上西药的同时服用中药健肝愈胃汤。两组疗程均为2个月。结果治疗组临床治疗总有效率89.3%。显效率46.4%;对照组临床治疗总有效率80.7%,显效率13.5%。两组比较有显著性差异（P〈0.05）。结论中药健肝愈胃汤、西药心得安、奥美拉唑、果胶铋联合治疗PHG疗效显著。     

奥美拉唑联合呋喃唑酮及阿莫西林治疗十二指肠溃疡疗效观察

目的 观察奥美拉唑联合呋喃唑酮及阿莫西林治疗十二指肠溃疡的疗效.方法 将十二指肠溃疡患者50例随机分为两组:治疗组26例,予以奥美拉唑每日清晨空腹口服20 mg,治疗4周,呋喃唑酮100 mg,3次/d,阿莫西林1000 mg,2次/d,治疗2周,治疗期间不加其他药物.对照组:奥美拉唑每日清晨空腹口服20 mg,治疗4周.结果 治疗组:治愈率53.85%,好转率42.31%,有效率98.16%;对照组:治愈率41.67%,好转率37.50%,有效率79.17%.治疗组和对照组总有效率经统计学处理有显著差异(P＜0.05).结论 奥美拉唑联合呋喃唑酮及阿莫西林治疗十二指肠溃疡能改善临床症状和促进溃疡愈合.     

Effect of omeprazole on the anticoagulant activity and the pharmacokinetics of warfarin enantiomers in rats

The effect of the proton pump inhibitor omeprazole on the anticoagulation and the pharmacokinetics of warfarin enantiomers was studied in rats. Omeprazole given intraperitoneally in a daily dose of 0.67 mg/kg over 8 days had no significant effect on the absorption, distribution and the total serum clearance values of the S- and R-enantiomers of warfarin. Omeprazole did not affect the pre-treatment baseline blood coagulation and the in vitro rat serum protein binding of warfarin enantiomers. In vitro study with rat liver microsomes showed that omeprazole had an inhibitory effect on the hydroxylation of warfarin enantiomers. Results obtained from in vivo urinary excretion study revealed that omeprazole inhibited the formation clearance of both S- and R-form oxidative metabolites, but increased that of the overall reductive metabolites, and the renal clearance of S- and R-enantiomers, of warfarin. As a consequence, the total serum clearance values for warfarin enantiomers remained unchanged and the hypoprothrombinaemic response produced by warfarin was not affected.     

奥美拉唑＋克拉霉素＋阿莫西林对胃溃疡患者 ET–1、 HMGB1、MMP–9、ERK1/2、PGE2 水平的影响

〔摘 要〕 目的：研究奥美拉唑＋克拉霉素＋阿莫西林对胃溃疡患者内皮素 –1（ET–1）、高迁移率族蛋白 B1（HMGB1）、 基质金属蛋白酶 –9（MMP–9）、细胞外信号调节激酶（ERK1/2）、前列腺素 E2（PGE2）水平的影响。 方法：选取 2021 年 1 月至 2022 年 12 月于鹤壁市人民医院治疗的 78 例胃溃疡患者,依据随机数字表法分为观察组、对照组,各 39 例。对照组 行奥美拉唑＋阿莫西林治疗,观察组行奥美拉唑＋克拉霉素＋阿莫西林治疗,比较两组患者溃疡愈合情况、临床症状消失 时间、治疗前后血清 ET–1、HMGB1、MMP–9、ERK1/2、PGE2 水平和不良反应。 结果：观察组患者溃疡愈合率为 97.44 %, 高于对照组的 79.49 %,差异具有统计学意义（P ＜ 0.05）;观察组患者反酸、嗳气、腹胀、腹痛症状消失时间均短于对 照组,差异具有统计学意义（P ＜ 0.05）;治疗后,观察组患者血清 ET–1、HMGB1、MMP–9 水平均低于对照组,血清 ERK1/2、PGE2 水平均高于对照组,差异具有统计学意义（P ＜ 0.05）;观察组患者总有效率高于对照组,差异具有统计 学意义（P ＜ 0.05）;治疗期间,两组患者均无明显不良反应。 结论：奥美拉唑＋克拉霉素＋阿莫西林治疗胃溃疡可提高 溃疡愈合率,缩短临床症状消失时间,改善患者血清 ET–1、HMGB1、MMP–9、ERK1/2、PGE2 水平,且无明显不良反应。     

洛赛克治疗症状性胃食管反流病95例临床观察

目的了解洛赛克强力抑酸作用对胃食管反流病(GERD)患者临床症状改善及胃镜下食管炎症改善情况.方法将95例GERD病人随机分为两组,用洛赛克(20mg qd)50例,雷尼替丁(150mg Bid)45例,疗程4周,停药2周后胃镜复查,观察临床症状及食管炎症改善情况.结果治疗组临床症状改善有效率为91.6%,对照组为50.4%.治疗组胃镜下食管炎症改善有效率为70%,对照组为29.2%.治疗组明显优于对照组.结论对GERD病人抑制胃酸分泌,减轻其对食管粘膜的损伤和改善临床症状洛赛克有较好的疗效,其作用已被公认,但在食管炎症愈合方面疗效不太满意,如与促动力药物合用,可望更高疗效.     

Helicobacter pylori clearance and serum gastrin and pepsinogen I concentrations in omeprazole treatment of duodenal ulcer patients

Objective: To determine which demographic factors may influence serum gastrin and pepsinogen I (PGI) levels in duodenal ulcer patients undergoing omeprazole treatment. Methods: We conducted an outpatient-based prospective study in the Veterans General Hospital, Taipei, to investigate the pharmacological effects on patients with duodenal ulcers receiving omeprazole treatment for 4 weeks. Sixty-eight patients (61 males/7 females, aged 25–73 years) with endoscopically confirmed duodenal ulcer were included. Gastrin and pepsinogen I levels were measured before and after treatment. Demographic factors including age, sex, smoking, ulcer healing and antral Helicobacter pylori colonization/clearance were analyzed, in order to measure their probable influences on serum gastrin and pepsinogen I levels. Results: Ulcer healing was seen in 92.6% of patients while 48 (70.6%) antral clearances were seen in 66 H. pylori colonized patients at the end of trial. Omeprazole monotherapy led to a marked elevation of serum gastrin (85.8 pg · ml⁻¹, SD 32.0 pg · ml⁻¹ vs 133.9 pg · ml⁻¹, SD 71.6 pg · ml⁻¹, P < 0.01), and pepsinogen I (111.0 ng · ml⁻¹, SD 36.7 ng · ml⁻¹ vs 253.6 ng · ml⁻¹, SD 64.8 ng · ml⁻¹, P < 0.01) levels when measured on day 29. Only patients showing antral H. pylori clearance exhibited an influence on the magnitude of pepsinogen I elevation following omeprazole monotherapy (143.9%, SD 67.3% vs 78.6%, SD 51.2%, P < 0.01). Moreover, the sensitivity and specificity of serum pepsinogen I variations were plotted on a receiving operating characteristic (ROC) curve. The 140% increased pepsinogen I level yielded a maximum accuracy of 80% specificity or 50% sensitivity to predict antral H. pylori clearance. Conclusion: Antral H. pylori clearance is at least partially responsible for the omeprzaole-induced hyperpepsinogenemia I. The magnitude of hyperpepsinogenemia I probably provides a non-invasive alternative for predicting H. pylori clearance. Received: 22 August 1996 / Accepted in revised form: 1 October 1998     

心理因素、幽门螺杆菌与消化性溃疡的关系

目的：探讨心理因索和幽门螺扦菌(HP)对消化性溃疡的发生、愈合、复发的影响。方法：以HAMD、I-lAMA、SDS量表检测正常人和消化性溃疡(PU)患者心理异常率；分别以奥美拉唑(奥)抑酸、羟基苄青霉素和甲硝唑根除HP(抗HP)、心理行为疗法治疗等方式治疗不同组PU患者。以胃镜检查PU愈合、复发状态；以尿素酶试验等检测HP感染率、复发率。结果：(1）心理异常率：正常人组：22．9％，PU组76．1％。(2)HP感染率：正常人组：51．4％，PU组86．4％。(3)HP根除率：A组(奥 抗HP 心理治疗)：92．3％，B组(奥 抗HP)：88．9％，C组(奥)：38．5％。(4)2年累积HP复发率：A组19．2％，B组22．2％，c组61．5％。(5)溃疡治愈率：A组96．2％，B组85．2％，c组84．6％。(6)2年累积溃疡复发率：A组3．9％，B组25．9％，C组42．3％。结论：心理因素和HP感染皆参与了PU的发病：在予以抗HP和心理行为治疗后，PU复发率降低。     

奥美拉唑肠溶片生物利用度测定

目的　考察奥美拉唑肠溶片人体相对生物利用度及生物等效性。方法　 10名健康男性志愿者 ,采用交叉给药方案 ,分别单剂量po 2 0mg国产奥美拉唑肠溶片和进口奥美拉唑胶囊 ,用高效液相色谱紫外检测法测定血浆中奥美拉唑浓度 ,进行人体相对生物利用度和生物等效性评价。结果　单次po 2 0mg国产奥美拉唑肠溶片和进口奥美拉唑胶囊后 ,达峰时间tmax分别为 3 0 1± 0 5 2h和 2 6 2± 0 76h ;峰值血药浓度Cmax分别为 5 4 3 5± 2 14 9ng·ml-1和 5 2 0 9± 16 7 8ng·ml-1;药时曲线下面积AUC0→∞ 分别为 10 2 3 0± 5 4 2 5h·ng·ml-1和 10 71 2± 5 73 8h·ng·ml-1。结论　国产奥美拉唑肠溶片的相对生物利用度为96 4 0 % ,主要参数的双单侧t检验 ,结果显示两种制剂为生物等效制剂。     

奥美拉唑联合莫沙比利治疗反流性食管炎

目的　观察奥美拉唑联合莫沙比利治疗反流性食管炎 (RE)的临床疗效和安全性。方法　将15 6例RE患者随机分为A组和B组各 78例 ,两组均予莫沙比利 5mgtid ,A组加服奥美拉唑 2 0mgqd ,B组加服雷尼替丁 15 0mgbid。分别于治疗前、治疗后 4周、8周观察临床症状及胃镜变化。结果　治疗后 4周临床总有效率A组明显高于B组 (P <0 0 1) ,食管粘膜病损愈合率A组高于B组 (P <0 0 5 ) ;治疗后 8周临床总有效率及食管粘膜病损愈合率比较 ,A组均明显高于B组 (P <0 0 1)。结论　奥美拉唑联合莫沙比利治疗RE疗效明显优于雷尼替丁联合莫沙比利。     

三联方案治疗Hp阳性消化性溃疡的疗效评价

目的探究甲硝唑、阿莫西林克拉维酸钾和奥美拉唑三联方案治疗幽门螺杆菌(Helicobacter pylori,Hp)感染阳性型消化性溃疡的效果,指导临床合理用药。方法随机选我院收治的Hp阳性消化性溃疡患者共190例,其中单用奥美拉唑治疗的95例患者作对照组,同时联用甲硝唑和阿莫西林克拉维酸钾的95例患者作观察组,对比两组患者疗效及不良反应。结果观察组总有效率(96.84%)显著高于对照组(84.21%),P0.05,存在显著性差异。结论甲硝唑、阿莫西林克拉维酸钾和奥美拉唑三联方案能够有效治疗Hp阳性消化性溃疡,建议临床普及应用。