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

The role of ACID suppression and helicobacter pylori eradication in the treatment of peptic ulcer

Objective To evaluate the role of Helicobacter pylori(Hp) eradication with /without acid suppression in the treatment of Hp positive peptic ulcer (PU).Methods 65consecutive cases diagnosed by endoscopy as PU with Hp infection (both histological examination and rapid urease test (RUT) positive) were included in the study.The patients were divided randomly into two groups.In group A (quadruple therapy),Omeprazole 20mg,colloidal bismuth subcitrate 240mg,metronidazole 400mg and tetracycline 500mg were used twice daily for 1 week.In group B(triple therapy),medicines were prescribed as above but omeprazole was not used.After an interval of 4 weeks,Hp eradication (histology,RUT and 14 C-urea breath test suggested negative) and PU healing were evaluated.Results 28 patients in group A and 26 in group B completed the study.In groups A and B,the Hp eradication rate was 89.3% and 61.5%( P <0.025),and the rate of ulcer healing was 85.7% and 69.2% respectively( P >0.05).In the patients whose Hp were eradicated,the ulcer healing rate was as high as 92% in group A and 93.7% in group B( P >0.05).While in the patients with persisted Hp positive,the ulcer healing rate in groups A and B was 33.3% and 30%,respectively ( P >0.05).The abdominal pain was relieved within 3.2 days on the average in group A and 8.8 days in group B( P <0.001).Conclusion Successful eradication of Hp guarantees an efficacious cure for over 90% of Hp positive PU,even without acid suppression,and in combination with omeprazole,the therapy can raise the Hp eradication rate and relieve abdominal pain more rapidly.