埃索美拉唑与奥美拉唑三联疗法治疗胃溃疡临床对照研究

目的对比埃索美拉唑与奥美拉唑三联疗法治疗胃溃疡的疗效及安全性。方法将72例胃溃疡活动期且幽门螺杆菌阳性患者随机分为A组和B组，均口服阿莫西林克拉维酸钾片0．457g及替硝唑片0．5g、每日1次，A组（34例）再口服埃索美拉唑镁肠溶片20mg，B组（38例）再口服奥美拉唑镁肠溶片20mg，均每日1次。治疗8周后，A组和B组分别继续单服埃索美拉唑20mg或奥美拉唑20mg，每日1次，继续治疗4周后复查胃镜并检测幽门螺杆菌、血清c-反应蛋白、白细胞介素6。结果A组和B组患者幽门螺杆菌根除率分别为85．29％和73．68％，溃疡愈合率分别为91．18％和71．05％；两组治疗后血清炎症因子c-反应蛋白、白细胞介素6均较治疗前显著降低（P〈0．01），且A组更明显（P〈0．05）。结论埃索美拉唑联合阿莫西林克拉维酸钾和替硝唑，较奥美拉唑三联疗法有更高的幽门螺杆菌根除率及溃疡愈合率，能更好地降低血清炎症因子水平，且不良反应少，值得临床推广。

Comparative Observation on Triple Therapies of Esomeprazole and Omeprazole for Treating Gastric Ulcer

Objective To compare the effect and safety of triple therapies of esomeprazole and omeprazole for treating gastric ulcer. Methods Seventy-two patients with active gastric ulcer and positive Helicobacter pylori（Hp） were randomly allocated into 2 groups treated by oral amoxicillin clavulanate potassium 0. 457 g and tinidazole 0. 5 g, once daily. In addition, the esomeprazole group（A, 34 cas- es） was given oral Esomeprazole Enteric-Coated Tablet 20 rag, once-daily, and the omeprazole group（B, 38 cases） was given oral Omeprazole Enteric- Coated Tablet 20 rag, once- daily. After 8- week treatment, the group A and B continuously took oral esomeprazole 20 mg and omeprazole 20 mg alone, once-daily. After continuous 4-week treatment, gastroscopy was performed again and Helicobacter pylori（HP）, CRP and interleukin-6（IL-6） were redetected. Results The HP eradication rates in the group A and B were 85.29% and 73.68% , respectively, the ulcer healing rates were 91.18% and 71.05% , respectively（ P 〉 0. 05）. The inflammatory factor CRP and IL-6 after treatment in both groups were significantly decreased than before treatment（P〈0.01）, hut the group A was more obvious（ P 〈 0. 05）. Conclusion The triple therapy of esomeprazole combined with amoxicillin clavulanate potassium and tinidazole has the higher HP eradication rate and the higher ulcer healing rate, better decreases the levels of serum inflammatory factor than the omeprazole triple therapy, with fewer adverse reactions, which is worthy of being clinically promoted.