雷贝拉唑三联疗法与奥美拉唑三联疗法治疗幽门螺杆菌阳性消化性溃疡的疗效对比

目的 观察雷贝拉唑三联疗法与奥美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性消化性溃疡的疗效差异.方法 选取2013年1月-2014年2月Hp阳性消化性溃疡患者90例,随机分为雷贝拉唑组42例和奥美拉唑组48例.雷贝拉唑组给予雷贝拉唑、阿莫西林、甲硝唑口服,连用7d后改为单独服用雷贝拉唑;奥美拉唑组用药除将雷贝拉唑更换为奥美拉唑外,其余同雷贝拉唑组.观察两组患者上腹疼痛、反酸、嗳气、腹胀、烧心或恶心等不适症状的缓解情况,停药4周后溃疡愈合情况,Hp根除率及药物不良反应的差异.结果 两组用药1d后症状明显改善,其中雷贝拉唑组30例症状缓解（71.43％）,奥美拉唑组23例症状缓解（47.92％）,两组比较差异显著（P＜0.05）;治疗7d后,两组症状改善无显著差异（P＞0.05）;停药后4周,雷贝拉唑组溃疡愈合总有效率为95.23％（40/42）,奥美拉唑组总有效率79.17％（38/48）,雷贝拉唑组总有效率显著高于奥美拉唑组（P＜0.05）;雷贝拉唑组39例Hp阴性（92.86％）,奥美拉唑组35例Hp阴性（72.92％）,两组差异显著（P＜0.05）.结论 雷贝拉唑三联疗法治疗Hp阳性消化性溃疡较奥美拉唑三联疗法起效更快,溃疡愈合率和Hp根除率更高.

Effect of Rabeprazole-based Triple Therapy Versus Omeprazole-based Triple Therapy for Patients with Helicobacter Pylori Positive Peptic Ulcer

OBJECTIVE To compare the clinical effects between rabeprazole-based triple therapy and omeprazole-based triple thera- py for patients with helicobaeter pylori（HP） positive peptic ulcer. METHODS A total of 90 patients with HP positive peptic ulcer were randomly divided into rabeprazole-based and omeprazole-based treatment group, with 42 and 48 patients, respectively. Patients in rabeprazole-based treatment group were oral administrated with rabeprazole, amoxicillin and metronidazole continuously for initial 7 days, then with rabeprazole monotherapy. Patients in rabeprazole-based treatment group were given similar triple therapy only switching rabeprazole to omeprazole. Abnormal reactions including epigastric pain, acid regurgitation, belching, abdominal distention, heartburn, nausea, gastric ulcer healing, and eradication of HP were observed between two groups. RESULTS Both of two groups showed therapeutic effect at first day of treatment, response rate was 71.43% in rabeprazole-based and 47.92% in omeprazole-based group, with a significant difference （P〈0.05）. There was no significant difference in response rate between two groups after 7 days （P〉0.05）. Rabeprazole-based group received higher overall response rate of ulcer healing compared to omeprazole-hased group 4 weeks after treatment （98.23%： 79.17%, P,~O.05）. number of patients achieved HP negative was 39（92.86%） in rabeprazole-based group and 35 （72.92%） in omeprazole-based group, with significant difference （P〈0.05）. CONCLUSION Rabeprazole-based triple therapy had a rapid onset and higher rate of ulcer response and HP eradication.