奥美拉唑新三联治疗十二指肠溃疡幽门螺杆菌再感染的疗效观察

目的观察奥美拉唑、左氧氟沙星及克拉霉素新三联治疗十二指肠溃疡幽门螺杆菌(Helicobacter pylori,Hp)再感染复发的临床疗效。方法将52例十二指肠溃疡Hp再感染复发患者随机分成两组。治疗组26例为奥美拉唑新三联疗法,即口服奥美拉唑20mg、左氧氟沙星200mg及克拉霉素500mg,均为2次/日,连服1周。对照组26例为奥美拉唑四联疗法,即口服奥美拉唑20mg、丽珠得乐220mg、阿莫西林1000mg及甲硝唑400mg,均为2次/日,连服1周,1周后两组继续服用奥美拉唑20mg,2次/日,连服4周,各组疗程结束后一个月复查胃镜。结果51例病人完成治疗及随访,对照组有1例失访。奥美拉唑新三联组与四联组疗法Hp再感染根除率分别为92.3%(24/26)、84.0%(21/25),溃疡愈合率分别为96.2%(25/26)、92.0%(23/25),副反应发生率分别为11.5%(3/26)、32.0%(8/25),差异均无显著性(P>0.05)。Hp根除组溃疡愈合率(100.0%)明显高于Hp未根除组(72.7%),差异有显著性(P<0.001)。结论奥美拉唑新三联组有较理想的Hp再感染根除率及溃疡愈合率,且副反应发生率低;奥美拉唑新三联疗法可作为根除十二指肠溃疡Hp再感染复发的一线治疗或失败后的补救治疗方案。

Efficacy of a new triple therapy with omeprazole in treatment of duodenal ulcer complicated with Helicobacter pylori reinfection

Objective To observe the effects of omeprazole (Ome) plus levofloxacin plus Clarithromycin(OVC) in the treatment of Helicoibacter pylori (H pylori) reinfection in patients with duodenal ulcer(DU). Methods Fifty-two patients with DU, who were confirmed by endoscopy with H pylori reinfection (confirmed by 14C-UBT and pathology), were randomly into two groups, OVC group: a new triple therapy with 1-week of Ome plus levofloxacin and clarithromycin, the control group: quadruple therapy with 1-week of Ome plus bismuth potassium citrate, amoxicillin and metronidazole(OBAM.), then two groups are received therapy with 4-week of Ome. Compared with two groups for ulcer healing, H pylori eradication and between the ulcer healing and H pylori reinfection eradication in DU and side effects of drugs. Results Fifty-one Patients are received therapy and followed up. The eradication rates of H pylori reinfection were 92.3%(24/26) and 84.0%(21/25) (P=0.627),respectively. The ulcer healing rates were 96.2%(25/26) and 92.0%(23/25) in OVC group and OBAM group, respectively(P>0.05). There was no significant difference of the side effects of OV group 11.5%(3/26) and OAM group 32.0%(8/25)(P=0.151). The ulcer healing rates were 100.0% and 72.7% respectively for H pylori eradication and failure of H pylori eradication group in patients (P<0.001). Conclusions The new triple therapy(OVC) was efficacy, it will be the first program and remedy treatment selected for H pylori reinfection or H pylori-infected patients after failure of other therapies.