灭Hp胶囊与新三联并用对溃疡愈合质量及溃疡复发的影响

目的　观察灭Hp胶囊与新三联并用对消化性溃疡的溃疡愈合质量及溃疡复发的影响。方法　 75例活动期消化性溃疡并Hp阳性患者随机分为 3组 :A组 (新三联组 ) :口服兰索拉唑 30mg (1次 /d) 克拉霉素 2 5 0mg(2次 /d) 阿莫西林 5 0 0mg (2次 /d) ,连用 10d ;B组 (灭Hp胶囊四联组 ) :口服新三联 灭Hp胶囊 6粒 (2次 /d) ,连用 2 8d;C组 (安慰剂组 ) :口服胃舒平 3片 (2次 /d) ,连用 2 8d。疗程结束后 4周复查胃镜 ,观察Hp根治和溃疡愈合情况 ,对溃疡愈合者行光镜及电镜检查 ,评价溃疡愈合质量 ,并停服所有药物 ,随访 5年。结果　A、B两组患者溃疡愈合率、Hp根治率分别为 10 0 0 %、 96 4 % ,88 0 %、 92 0 % ;与安慰剂组的溃疡愈合率 (2 0 0 % )、Hp根治率 (0 )间差别均有显著性意义 (P <0 0 0 5 )。A、B两组与C组的溃疡愈合质量间的差别亦有显著性意义 (P <0 0 5 )。A组和B组溃疡复发率分别为 4 0 %和 10 0 % ,明显低于安慰剂的溃疡复发率 (10 0 % ) ,溃疡复发者均溃疡愈合质量不佳。结论　灭Hp胶囊四联疗法不但具有与新三联相当的Hp根治率和溃疡愈合率 ,而且更有显著提高溃疡愈合质量、降低溃疡复发的作用

The Effect of the Treatment Combined Traditional Chinese and Western Medicine on the Quality of Peptic Ulcer Healing and Ulcer Relapse in Double-blind Observation

Objective The observe the effect of Hp quadruple therapy on the quality of peptic ulcer healing and ulcer relapse with combined traditional Chinese and Western medicine.Methods 75 patients with active peptic ulcer and positive Hp were randomly divided into three groups: group A (new triple therapy): lansoprazole 30mg q.d. plus clarithromycin 250mg b.i.d. plus amoxycillin 500mg b.i.d. for 10 days; group B (killing Hp quadruple therapy): the three above drugs for the same use of 10 days plus recipe of killing Hp 6 capsules b.i.d.for 4wk; group C (Placebo): gastropine 3tab b.i.d. for 28 days. Gastroscope was reexamined after 4 weeks when the course of treatment was finished, the radical cure of Hp and the quality of ulcer healing were observed. The patients with ulcer therapy were examined under optic and electric microscopy. The patients with healed ulcer stopped taking any medicine and were followed for 5 years.Results The healing rate both in group A and B (88% and 100% vs 20% in C, respectively, P<0.005)and the Hp eradication rate in groups A and B (92% and 96.4% vs 0.0% in C, respectively,P<0.05)were significantly higher than those in group C. The quality of ulcer healing in group B better than the those in group A and C; The ulcer relapse rates in group A and B were lower than those in group C. All recurrent ulcers had poor quality in ulcer healing.Conclusion Killing Hp quadruple therapy not only has the same Hp radical cure and ulcer healing rate, but also improves the quality of ulcer healing and decreases the ulcer relapse rate.