埃索美拉唑、克拉霉素与甲硝唑联合治疗消化性溃疡65例

目的研究埃索美拉唑、克拉霉素、甲硝唑三联治疗消化性渍疡的疗效。方法将126例经内镜诊断并检测证实幽门螺杆菌（Hp）阳性的消化性溃疡患者随机分为两组。治疗组65例，给予埃索美拉唑20mg＋克拉霉素500mg＋甲硝唑400mg，每日2次，共7d；对照组61倒，给予奥美拉唑20mg＋克拉霉素500mg＋甲硝唑400mg，每日2次，共7d。疗程结束4周后复查胃镜并检测Hp，观察腹痛缓解率、溃疡愈合率，Hp根除率及用药后的不良反应等。结果治疗组组第1d和第2d腹痛缓解率分别为33．8％和53．8％，高于对照组的16．4％和39．3％，有显著性差异（P〈0．05）。治疗组和对照组溃疡治愈率分别为90．8％和86．9％，治疗组和对照组Hp根除率分别为90．8％和86．9％，差异无显著性（P〉0．05）。两组用药后不良反应少，有较好的安全性。结论埃索美拉唑、克拉霉素、甲硝唑三联疗法治疗Hp阳性的消化性溃疡安全有效，腹痛缓解速度优于奥美拉唑三联疗法。

Clinical observation on triple therapy for 65 cases of peptic ulcer with esomeprazole,clarithromycin and metronidazole

Objective To investigate the effect of esomeprazole,clarithromycin and metronidazole triple therapy for helicobactor pylori（Hp） infection in peptic ulcer patients. Methods 126 cases with peptic ulcer and Hp infection were divided into two groups. Treatment group （65 cases） treated with esomeprazole （ 20 mg）, clarithromycin （ 500 mg） and metronidazole （ 400 mg） twice daily, and control group （ 61 cases） treated with omeprazole（ 20 mg） , clarithromycin （500 mg） and metronidazole （400 mg）twice daily . The treatment lasted for 7days. After which abdominal pain relief rate, ulcer healing rate and eradication rate of Hp as well as effects of the medication were evaluated and compared. Results On the first and the second days of medication , the abdominal pain relief rates were 33.8% and 53.8% respectively in treatment group ,significantly higher than those in control group （16.4% and 39.3% ）. There were significant differences between the two groups respectively（ P 〈0.05 ）. Ulcer healing rate were 90.8% and 86.9% in treatment group and control group ,and eradication rate of Hp were 90.8% and 86.9% in treatment group and control group. There were no significant differences between the two groups（ P 〉 0.05 ）. The adverse effects of the medication were rare in both groups without significant differences. Conclusion Esomeprazole,clarithromycin and metronidazole triple therapy may effectively eradicate Hp infection and promote petic ulcer healing with good tolerance ,capable of achieving more speedy pain relief than omeprazole -based therapy.