摘要
目的为更快速、高效、经济而安全地根除幽门螺杆菌（Ｈｐ），减少Ｈｐ耐药性和复发率．方法用四组对照的方法研究了二日疗法根除Ｈｐ及治疗Ｈｐ相关性消化性溃疡（ＰＵ）和非溃疡性消化不良（ＮＵＤ）的近期效果和随访结果．组１，４４例，口服雷尼替丁０１５ｇ，２次／ｄ；甲硝唑０４ｇ，３次／ｄ；丽珠得乐１０ｇ，４次／ｄ；４ｗｋ．组２，４４例，以奥美拉唑（２０ｍｇ，２次／ｄ）代替雷尼替丁，余同组１．组３，３７例，口服庆大霉素１６万Ｕ，３次／ｄ；雷尼替丁０３ｇ，２次／ｄ；羟氨苄青霉素０７５ｇ，３次／ｄ；丽珠得乐１０ｇ，４次／ｄ；２ｄ．组４，３４例，以四环素（０７５ｇ，４次／ｄ）代羟氨苄青霉素，余同组３．结果治疗后患者症状消失时间（ｄ）组３（２３±１２），组４（２４±１２）明显短于组１（６７±２５）和组２（６５±２７，Ｐ＜００１）．治疗１ｍｏ后Ｈｐ根除率组３（９７３％）及组４（９４１％）明显高于组１（７０５％）和组２（７２７％，Ｐ＜００１）．溃疡愈合率、炎症消失率四组无显著差异．随访６ｍｏ～３９ｍｏ，Ｈｐ再检出率四组分别为４５％，６８％，８１％和５９％．结论二日四联疗法根除Ｈｐ快速、?
AIM To seek a quicker, more effective, less expensive and low side effect therapeutic regimen for eradication of H.pylori(Hp) . METHODS The effect of two day therapy for peptic ulcer (PU) and nonulcer dyspepsia (NUD) and follow up results in patients with Hp infection were studied according to randomized and four group controlled protocol. Group 1 (44 cases) received ranitidine (150mg×2)+metronidazole (0 4g×3)+bismuth subcitrate (1 0g×4) for four weeks. In group 2 (44 cases) ranitidine was replaced by omeprazole (20mg×2) and others were the same as in group 1. Group 3 (37 cases) took gentamycine (160 000U×3)+ranitidine (0 3g×2)+amoxycillin (0 75g×3)+bismuth subcitrate (1 0g×4) for two days. Group 4 (34 cases) received tetracycline (0 75g×4) in stead of amoxycillin and others were the same as in group 3. RESULTS The disappearance time (d) of the symptoms was shorter in groups 3 (2 3±1 2) and 4 (2 4±1 2) than in groups 1 (6 7±2 5) and 2 (6 5±2 7) ( P <0 01) after the treatment. The eradication rates of Hp three months after the treatment were higher in groups 3(97 3%) and 4 (94 1%) than in groups 1 (70 5%) and 2 (72 7%, P <0 01). The healing rates of PU and the disappearance rates of inflammation related to Hp were similar in the four groups one month after treatment. The relapse rates of Hp during follow up of 6-39 months were 4 5%, 6 8%, 8 1%, and 5 9% in four groups, respectively. CONCLUSION Two day therapy for eradication of Hp is a quick, effective, less expensive, safe and convenient therapeutic approach, without drug resistance.
关键词
幽门螺杆菌
螺杆菌感染
药物疗法
消化性溃疡
Helicobacter pylori
Helicobacter infections/drug therapy
peptic ulcer/drug therapy
dyspepsia/drug therapy
ranitidine/therapeutic use
antibiotics/therapeutic use
