泮托拉唑、阿莫西林、呋喃唑酮三联疗法治疗幽门螺杆菌相关性十二指肠溃疡疗效观察

目的:对比观察国产泮托拉唑与奥美拉唑及雷尼替丁+铋剂对十二指肠溃疡(DU)的治愈率及幽门螺杆菌(Hp)的根除率。方法:104例Hp相关性DU门诊患者,按2:1:1随机分成A组52例、B组28例和C组24例。A组:泮托拉唑40mg qd+阿莫西林1000mg bid+呋喃唑酮100mg bid×7d,继服泮托拉唑40mg qd×21d;B组:奥美拉唑20mg bid+阿莫西林1000mg bid+呋喃唑酮100mg bid×7d,改奥美拉唑20mg qd×21d;C组:雷尼替丁150mgbid+丽珠得乐100mg qid+阿莫西林500mg tid+甲硝唑400mg tid×14d,继服雷尼替丁150mg bid×28d。结果:ABC三组溃疡治愈率分别为94.2％、92.9％和62.5％;Hp根除率分别为94.2％、92.9％和66.7％。结论:由泮托拉唑组成的低剂量短程新三联疗法,对DU的疗效和Hp清除率与奥美拉唑组比较无明显差异(P>0.05),而明显优于雷尼替丁、铋剂四联疗法(P<0.01),成本效益比仅为B组的1/2～2/3,药物副反应不足C组的1/3。方案A是一种新的高效、经济、安全实用的Hp根除方案。

Triple Therapy with Pantoprazole, Amoxicillin and Furazolidone for Treatment of Duodenal Ulcer Associated with Helicobacter Pylori

Objective: To explore the optimal regimens for eradication of Helicobacter pylori (HP) and the treatment of duodenal ulcer (DU). Methods:The 104 patients with DU assoiated with Hp were randomly divided into three groups. Group A (n = 52) were treated with triple therapy of pantoprazole 40mg qd amoxicillin(amo) 1000mg bid farazolidone (Fur) 100mg bid for 1 week, and were treated with Pan 40mg/day for 3 weeks after anti - Hp therapy;Group B( n =28), were treated with triple therapy of omeprazole (ome )20mg bid Amo 1000mg bid Fur 100mg bid for 1 week, and were treated with Ome 20mg/day for 3 weeks after anti-HP therapy. Group C ( n = 24) were treated with fourfold therapy of renitidine (Ren) 150mg bid Tripotassium Dicifobismuphate (Tri) 100mg qid Amo 500mg tid Miediling (Mie) 400mg lid for 2 weeks,and were treated with Ren 150mg bid for 4 week after anti - HP therapy, after month of anti-HP therapy the endoscopy and examination of HP were repeated. Results: The healing rates of active DU in group A,B,C were 94.2% ,92.9% ,62.5% .respectively.The eradication rates of HP in group A.B.C were 94.2% ,92. 9% ,66.7% , and the occurrence of side effects in group A,B,C were 7.7% ,7.1 % and 29.2% .respectively. The group A is quite different from the group C in the healing rates of ulcer, the eradication rates of HP and the occurrence of side effects ( P< 0. 01) .while the group A has no marked difference with the group B (P >0.05). Conclusion :The regimens A.B are highly effective in the eradicetion of HP infection and the healing of active DU. But the regimen A is optimal and practical because of Little side effect, lower cost and no resistance of HP strains.