三联疗法对非糜烂性反流病合并H pylori感染患者预后的影响  

Efficacy of triple therapy and its effect on prognosis of H pylori infected patients with non-erosive reflux disease

作　　者：朱金水[1] 宋明全[1] 朱励[1] 王龙[1] 陈金联[1] 达炜[1] 孙群[1] 王如华[1] 

机构地区：[1]上海交通大学附属第六人民医院消化科,上海市200233

出　　处：《世界华人消化杂志》2006年第19期1924-1927,共4页World Chinese Journal of Digestology

摘　　要：目的：探讨幽门螺杆菌(H pylori)根除对非糜烂性反流病(non-erosive reflux diseage,NERD)合并H pylori感染患者疗效及预后．方法：120例非糜烂性反流病合并H pylori感染患者随机分为：对照组60例,仅口服洛赛克(20 mg,2次/d)1 wk；三联疗法组60例：口服洛赛克(20 mg)和克拉霉素(500 mg)及阿莫西林(500 mg),均每天2次,连续1 wk,1 wk后非糜烂性症状缓解患者,开始口服洛赛克20 mg/d的维持治疗阶段至3 wk：试验结束后6 mo均行胃镜复查及^(13)C呼气试验．结果：试验结束后三联疗法组57例患者H pylori阴性(95．0%),对照组5例转阴(8．3%),两组H pylori根除率差异显著(P＜0．01)；对照组患者残胃萎缩及残胃肠化较H pylori根除组明显增多(P＜0．05),三联疗法但对反流症状烧灼感及进食后梗阻或异物感的改善不明显(P＞0．05)结论：三联疗法根除H pylori后对非糜烂性反流病合并H pylori感染患者的胃窦部的肠化生及不典型增生有防治疗效,但对反流症状烧灼感及进食后梗阻或异物感的改善不明显．AIM： To investigate the efficacy of triple therapy and the effect of H pylori eradication on the prognosis of patients with non-erosive reflux disease （NERD）. METHODS： One-hundred and twenty H pylori infected patients with NERD were randomly and averagely divided into group A and B. The patients in group A received triple therapy （20 mg Losec plus 500 mg Clarithromycin plus 500 mg Amoxicillin, twice a day） for 1 wk, and the ones in group B served as the controls （treated with 20 mg Losec twice a day）. From week 2, the patients, whose symptoms of non-erosive reflux disease were alleviated, in both groups were orally treated only with 20 mg Losec once a day until the end of week 3. Gastric endoscopy and 13C breath test were performed at the end of 12 mo. RESULTS： 13C breath test showed that the rate of H pylori eradication was significantly higher in group A than that in group B （95% vs 8.3%, P〈0.01）. The degrees of corpus atrophy and intestinal metaplasia were also markedly alleviated in group A （P〈0.01）. However, the scores for the symptoms such as heartburn or swallow abnormality had no significant difference between the two groups （P〉0.05）. CONCLUSION： Triple therapy is effective in the eradication of H pylori and treatment of intestinal metaplasia and corpus atrophy, but not in the improvement of heartburn or swallow abnormality.

关 键 词：三联疗法 Hpylori根除 非糜烂性反流病 疗效 

分 类 号：R571[医药卫生—消化系统]