雷贝拉唑﹑云南白药联合左氧氟沙星治疗幽门螺杆菌阳性消化性溃疡效果分析

目的观察雷贝拉唑﹑云南白药联合左氧氟沙星三联疗法治疗幽门螺杆菌(helicobacterpylori,Hp)阳性消化性溃疡的疗效及安全性。方法选取2010年4月—2012年7月收治的患者97例,随机分为治疗组49例和对照组48例。治疗组给予雷贝拉唑片20 mg晨服,1次/d;左氧氟沙星片0.2 g,2次/d;云南白药胶囊0.5 g,3次/d口服。对照组给予奥美拉唑片20 mg+克拉霉素片500 mg+阿莫西林胶囊1.0 g,2次/d口服,疗程2周。2周后治疗组单独予雷贝拉唑片20 mg晨服,1次/d;云南白药胶囊0.5 g,3次/d口服。对照组单独给予奥美拉唑片20 mg,2次/d口服,用药4周,总疗程6周。停药4周后上述两组均复查胃镜及Hp,计数资料采用χ2检验,P0.05为差异有统计学意义。结果 Hp根除率治疗组93.88%,对照组72.92%,两组比较差异有统计学意义(P0.05)。治疗组溃疡治愈率91.84%、总有效率97.96%;对照组分别为62.50%、79.17%,两组比较差异均有统计学意义(均P0.05)。所有患者治疗后,根据Hp根除与否分为两组,Hp根除组81例,溃疡愈合72例,Hp未根除组16例,溃疡愈合3例,两组比较差异有统计学意义(P0.05)。治疗组出现不良反应3例,对照组出现不良反应4例,所有患者肝肾功能及血﹑尿常规等指标在治疗前后均无异常变化。治疗后1年随访,治疗组复发率4.44%,对照组23.33%,比较差异有统计学意义(P0.05)。结论雷贝拉唑﹑云南白药联合左氧氟沙星三联疗法具有Hp根除率和溃疡治愈率高﹑复发率低﹑不良反应小等特点,是治疗HP阳性消化性溃疡较理想的方案。

The triple therapy of rabeprazole,Yunnan Baiyao combined with levofloxacin for Hp -positive peptic ulcer WANG Jun

Objective To observe the efficacy and safety of the triple therapy of rabeprazole, Yunnan Baiyao combined with levoiloxacin for HP - positive peptic ulcer. Methods 97 cases treated in out center from April 2010 to July 2012 were randomly divided into treatment group （ n = 49） and control group （ n = 48）. Treatment group was given oral rabe- prazole 20mg once daily; levofloxacin tablets O. 2 g twice daily; Yunnan Baiyao capsule 0.5g three times daily; control group was given oral omeprazole20mg, clarithromycin tablets 500 mg and amoxicillin capsules 1.0g twice daily. The treat- ment course lasted 2 weeks. After two weeks of treatment, treatment group was given oral rabeprazole 20mg once daily, Yunnan Baiyao capsule O. 5g three times daily;while control group was only given oral omeprazole 20mg twice daily for four weeks. The total treatment course lasted 6 weeks. Four weeks after drug discontinuation, both groups were reexamined for HP by gastroscopy. Count data were processed by X2 test, P 〈 0.05 was considered significantly different. Results Hp e- radication rate was 93.88% in treatment group and72.92% in control group,the difference was statistically significant （P 〈 0.05 ）. The ulcer healing rate and total efficiency rate were 91.84% and 97.96% respectively in treatment group, while they were 62.50% and 79.17% respectively in control group, there were significant differences between the two groups （P 〈 0.05）. After treatment, all cases were divided into two groups based on their condition of HP eradication, group with HP eradication （ n =81, 72 cases with healed ulcer）, group without HP eradication（ n = 16, 3 cases with healed ulcer）, there was significant difference between two groups （P 〈 0.05 ）. Three cases developed adverse reactions in treatment group and 4 cases in control group. No abnormal changes occurred in all patients, such as liver and kidney function , blood, urine routine before and after treatment. After 1 - year follow - up after treatment, the relapsed rat