根除幽门螺杆菌三联疗法临床观察

目的　观察以质子泵抑制剂 (PPI)、克拉霉素为中心的三联疗法治疗幽门螺杆菌 (HP)阳性十二指肠溃疡的疗效 ,比较甲硝唑和痢特灵的疗效及副作用 ,筛选理想的三联疗法。方法　胃镜确诊十二指肠溃疡并经病理组织学及 14 C-尿素呼吸试验证实 HP感染者 184例 ,随机分成 2组 ,A组用洛塞克、克拉霉素及甲硝唑 ,B组用洛塞克、克拉霉素及痢特灵 ,每日 2次 ,连续 7d,停药 4周后复查胃镜观察溃疡愈合程度 ,同时经 14 C-尿素呼吸试验及胃镜证实 HP根除情况。结果　溃疡总愈合率 :A组 91.4 % (85 / 93) ,B组 93.4 % (85 / 91) ,2种疗法比较差异无显著意义 (P >0 .0 5 ) ;HP根除率 :A组 90 .3% (84 / 93) ,B组 93.4 % (85 / 91) ,2种疗法比较差异无显著意义 (P >0 .0 5 ) ;轻度不良反应 :A组 16 .1% (15 / 93) ,B组 4 .4 % (4/ 91) ,B组反应明显轻于 A组 (P <0 .0 5 )。结论　 2组三联疗法根除 HP及治疗十二指肠溃疡均有良好疗效 ;痢特灵具有抗 HP作用强、无耐药性、价格低廉、副作用少等优点 ,可替代甲硝唑配伍于洛塞克、克拉霉素的三联疗法中 ,是一种理想的适合国情的根除 HP方案

The clinical study on the triple therapy for the eradication of Helicobacter pylori infection

Objective In order to observe the efficacies on eradicating Helicobacter pylori(HP) and healing duodenal ulcer(DU), and to choose ideal triple therapeutic regimen that mainly include omeprazole and clarithromycin,and metronidazole.Methods 184 patients with DU were infected by HP diagnosed by gastroscope,histology and 14C urea breath test. All patients were allocated randomly into group A and group B.Group A:omeprazole 20 mg bid, clarithromycin 250 mg bid and metronidazole 400 mg bid; Group B:omeprazole 20 mg bid, clarithromycin 250 mg bid and furanzolidone 100 mg bid.The course of therapy were 7 days. After 4 weeks of discontinuing these pills, the results of HP eradication, status of ulcer healing and side effects were checked and recorded.Results The total rates of ulcer healing in group A was 91.4%, in group B was 92.3%. The HP eradication rate in group A and B were 90.3% and 93.4% respectively.The differences between the two regimens weren't significant(P>0.05).Significant differences in mild side effects were observed (P<0.05) which were 16.1% and 4.4% in group A and group B,respectively.Conclusions Two groups that include PPI triple therapeutic regimens can effectively eradicate HP and heal DU.Furanzolidone possesses the advantages of good efficacy,no resistance,cheap and mild side effects.So it could replace metronidazole to be used in the triple therapeutic regimens along with omeprazole and clarithromycin.It is suitable to the native condition.