奥美拉唑或兰索拉唑、阿莫西林、呋喃唑酮短程三联疗法根除幽门螺杆菌

目的探索根除率较高、价廉、安全实用的HP根除方案.方法137例消化性溃疡或糜烂性胃窦炎患者,随机分为3组A组44例,以奥美拉唑20mg+克拉霉素250mg+替硝唑500mg每天2次,疗程7天,即Bazzoli方案;B组47例,以奥美拉唑20mg+阿莫西林1000mg+呋喃唑酮100mg,每天2次,疗程7天;C组46例,以兰索拉唑30mg每天1次,阿莫西林1000mg+呋喃唑酮100mg每天2次,疗程7天.活动期溃疡患者抗HP治疗后继服奥美拉唑20mg或兰索拉唑30mg,每天1次,3周.抗HP治疗结束1月后复查胃镜并检测HP.结果A、B、C3组的HP根除率分别为90.9%、87.2%和89.1%;活动期溃疡愈合率分别为100%、93.8%和100%;糜烂性胃窦炎愈合率分别为85.2%、79.2%和92.2%;副反应发生率分别为13.6%、6.4%和8.7%.各组间差异无显著性,P＞0.05.A、B、C3组每例抗HP所需费用分别为544.5元、309.0元和170.5元.结论方案B、C是2种新的、根除率较高、价廉、安全实用的HP根除方案.

Short-term Triple Therapy with Omeprazole or Lansoprazole, Amoxicillin and Furazolidone for Eradication of Helicobacter Pylori Infection

Purpose: To explore the optimal regimens for the eradication of helicobacter pylori (HP). Methods: The 137 patients with HP associated peptic ulcer or chroic erosive antral gastritis were randomly divided into three groups. Group A(n=44)were treated with triple therapy of omeprazole (Ome) 20 mg clarithromycin 250 mg tinidazole 500 mg bid for 1 week(Bazzoli regimen). Group B(n=47) were treated with triple therapy of Ome 20 mg amoxicillin (Amo) 1 000 mg furazolidone (Fur) 100 mg bid for 1 week. Group C(n=46) were treated with triple therapy of lansoprazole (Lan) 30 mg qd, Amo 1 000 mg Fur 100 mg bid, for I week.The patients of active peptic ulcer were treated Ome 20 mg/day or Lan 30 mg/day for 3 week after anti*.HP therapy. One month after anti*.HP therapy endoscop and examination of HP were repeated. Result: The eradication rates of HP in group A, B, C were 90.9%, 87.2% and 89.1%, respectively. The healing rates of active ulcer in group A, B, C were 100%, 93.8% and 100%, respectively. The healing rates of antral erosion in group A, B, C were 85.2%, 79.2% and 72.2%, respectively. The occurrence of side effects in group A, B, C were 13.6%, 6.4% and 8.7 %, respectively. Result of the three groups show no significant difference (P>0.05). The cost of anti*.HP therapy every patient in group A, B, C were 544.5, 309.0 and 170.5 (RMB,yuan), respectively. Conclusions: The three short*.term triple therapies are highly effective in the eradication of HP infection and healing of active ulcer and antral erosion, and are well tolerated. But the regimen B, C is optimal and practical, because of fewer side effects, lower cost and no resistance of HP strains.