序贯疗法治疗幽门螺杆菌阳性胃溃疡的临床分析

目的比较序贯疗法与传统三联疗法治疗幽门螺杆菌（Hp）阳性胃溃疡的疗效与安全性。方法选取84例经胃镜检测证实为Hp阳性胃溃疡病例，随机分为两组：治疗组，前5d予雷贝拉唑、阿莫西林，后5d予雷贝拉唑、替硝唑、克拉霉素治疗；对照组予雷贝拉唑、阿莫西林、克拉霉素治疗10d。随后两组均进行雷贝拉唑巩固治疗4周，疗程结束后均行胃镜复查检测。结果疗程结束时，治疗组溃疡愈合率87．8％，对照组溃疡愈合率86．05％，两组愈合率比较无显著性差异（P〉0．05）；治疗组HP阴转率为92．68％，对照组Hp阴转率为83．72％，两组Hp阴转率比较具有显著性差异（P〈0．05）。结论10d序贯疗法治疗Hp的HP阴转率较传统三联疗法高，溃疡愈合率相当，且副作用少，易耐受，安全可靠。

Sequential therapies for Helicobacter pylori-positive gastric ulcer clinical analysis

Objective To compare sequential therapy with the traditional triple therapies for Helicobacter pylori （Hp）-positive gastric ulcer and security. Methods 84 cases detected by endoscopy confirmed Hp-positive patients with gastric ulcer were randomly divided into two groups： the treatment group, before the therapy of the combination of rabeprazole, amoxicillin and rabeprazole for 5d,tinidazole, clarithromycin mixture therapy of 5d;control group, rabeprazole, Amoxicillin,clafithromycin treatment of 10d. Both groups were followed for consolidation therapy of rabeprazole for 4 weeks after treatment underwent endoscopy review test. Results at the end of treatment, the treatment group 87.8% ulcer healing rate, ulcer healing rate of the control group was 86.05%, the healing rate between the two groups there was no significant difference （P〉0.05）; treatment group HP negative conversion rate was 92.68%, control Group HP negative conversion rate was 83.72%, compared two groups of HP negative rate was significant difference （P 〈0.05）. Conclusion 10d sequential therapy of HP Hp negative rate higher than the traditional triple therapy, ulcer healing rate is quite, the side effects is less, tolerable, safe and reliable.