不同质子泵抑制剂三联疗法治疗幽门螺杆菌阳性消化性溃疡疗效的比较

目的比较使用不同质子泵抑制剂(奥美拉唑、兰索拉唑和埃索美拉唑)三联疗法治疗幽门螺杆菌阳性消化性溃疡的疗效。方法将内镜诊断为幽门螺杆菌阳性的消化性溃疡患者120例分为以下三组:①奥美拉唑三联疗法组40例;②兰索拉唑三联疗法组40例;③埃索美拉唑三联疗法组40例。用药结束1个月后复查胃镜,检测幽门螺杆菌。结果奥美拉唑、兰索拉唑和埃索美拉唑治疗组的溃疡愈合率分别为75.0%、80.0%和92.5%;治疗总有效率分别为90.0%、92.5%和97.5%。埃索美拉唑治疗组的溃疡愈合率及治疗总有效率均明显高于其它两组,奥美拉唑治疗组和兰索拉唑治疗组的溃疡愈合率及治疗总有效率没有明显差异。奥美拉唑、兰索拉唑和埃索美拉唑治疗组的幽门螺杆菌根除率分别为70.0%、77.5%和87.5%,埃索美拉唑治疗组的幽门螺杆菌根除率明显高于其它两组,奥美拉唑治疗组和兰索拉唑治疗组的幽门螺杆菌根除率没有明显的统计学差异。结论三组三联疗法方案均能有效治疗消化性溃疡,并有效地根除幽门螺杆菌,但埃索美拉唑三联疗法的效果明显优于其它两种方案。

Effects of Different Proton Pump Inhibitor-Based Triple Therapy in the Treatment of Helicobacter Pylori

Objective To compare the efficacy of different proton pump inhibitor,such as omeprazole,lansoprazole and esomeprazole-based triple therapy in the treatment of Helicobacter pylori(H.pylori)-positive peptic ulcer.Methods 120 patients with H.pylori positive peptic ulcers were divided into 3 different groups treated with different proton pump inhibitor-based triple therapy,omeprazole 20 mg bid,lansoprazole 30 mg bid and esomeprazole 40 mg bid for one week.All patients were given amoxicillin 1 g bid and metronidazole 400 mg in this week.One month after treatment,the healing rate of peptic ulcer and the eradication rate of H.pylori were evaluated by endoscopy.Results The ulcer healing of rate in omeprazole,lansoprazole and esomeprazole-based triple therapy group was 75.0%,80.0% and 92.5% and the total effective rate was 90.0%,92.5% and 97.5%.The healing rate and the total effective rate of esomeprazole-based triple therapy group were much higher than the other two groups,however,there was no different significance between omeprazole and lansoprazole group.The H.pylori eradication rate in omeprazole,lansoprazole and esomeprazole-based triple therapy group was 70.0%,77.5% and 87.5%.The H.pylori eradication rate of esomeprazole-based triple therapy group was much higher than the other two groups,but there was no different significance between omeprazole and lansoprazole group.Conclusions All of the three triple therapies are effective for curing peptic ulcer and H.pylori eradication,but esomeprazole-based triple therapy is better than the other two therapies.