雷贝拉唑及雷尼替丁枸橼酸铋的短程四联疗法根除幽门螺杆菌感染  

Quadruple therapy of rabeprazole and ranitidine bismuth citrate for eradicating helicobacter pylori infection

作　　者：冯志松[1] 黄涛[1] 冯迎春[1] 贺国斌[1] 黄旻[1] 廖娟[1] 

机构地区：[1]川北医学院附属医院消化科,四川南充637000

出　　处：《中华临床医师杂志（电子版）》2008年第1期35-38,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的观察雷贝拉唑与雷尼替丁枸橼酸铋(Ranitidinebismathcitrate,RBC)联合的五天四联疗法根除幽门螺杆菌(Helicobacterpylori,Hp)的疗效及安全性。方法选择Hp感染的活动期溃疡或慢性糜烂性胃窦炎患者,随机分为A、B、C、D四组。分别用雷贝拉唑三联七天疗法、RBC三联七天疗法、雷贝拉唑与三甲二枸橼酸铋联合四联七天疗法和雷贝拉唑与RBC联合四联五天疗法根除Hp治疗,活动期溃疡病例抗Hp治疗后继续服雷贝拉唑10mg,1次/d,疗程2周。观察Hp的根除率、活动期溃疡和糜烂性胃窦炎的愈合率以及副作用的发生率。结果雷贝拉唑与RBC联合五天四联组Hp根除率(97.7%)显著高于雷贝拉唑三联组(72.7%)或RBC三联组(75.6%)(P<0.05),亦高于雷贝拉唑与三甲二枸橼酸铋联合四联组(88.4%),但差异无统计学意义(P>0.05)。雷贝拉唑与RBC联合的五天四联组与其他三组对活动期溃疡愈合率较接近;高于其他三组对糜烂性胃窦炎的愈合率,但差异无统计学意义(P>0.05)。不良反应发生率,雷贝拉唑三联组(8.9%)、RBC三联组(6.7%)和雷贝拉唑与RBC联合四联组(8.9%)较类似。均低于雷贝拉唑与三甲二枸橼酸铋联合四联组(20.0%),但差异无统计学意义(P>0.05)。结论雷贝拉唑与RBC联合四联疗法可获得高Hp根除率,不良反应少、疗程短,值得进一步试用。Objective To evaluate the efficacy and security of the quadruple chemotherapy which is composed of rabeprazole and ranitidine bismuth citrate （RBC）. Methods Patients with peptic ulcer or chronic erosion gastritis and Hp infection were randomly allocated into 4 therapy group. Group A ：Rabeprazole 10 mg bid ＋ amoxicillin 1000 mg bid ＋ furaltadone 100 mg bid, 7 days; Group B： RBC 350 mg bid ＋ amoxicillin 1000 mg bid ＋ furaltadone 100 mg bid,7 days; Group C： Rabeprazole 10 mg bid ＋ colloidal bismuth subcitrate 240 mg bid ＋ amoxicillin 1000 mg bid ＋ furaltadone 100 mg bid,7 days; Group D： Rabeprazole 10 mg bid ＋ RBC 350 mg bid ＋ amoxicillin 1000 mg bid ＋ furaltadone 100 mg bid, 5 days. Results Group D achieved 97.72% of Hp eradication rate, significantly higher than Group A （72. 7% ） and Group C （ 75. 6% ） （ P 〈 0. 05 ）, and also slightly higher than Group C （ 88.4% ） （ P 〉 0. 05 ）. The ulcer healing rate of four groups was close to each other. The erosion gastritis healing rate of group D was higher than that of the other three groups, but no significant difference（ P 〉0.05）. The adverse effect rate of Group A （8.9%）, Group B（ 6.7% ）and Group D （8.9%）was almost not different. They were lower than Group C （20. 0% ）, but no significant difference （ P 〉 0. 05 ）. Conclusion The quadruple chemotherapy of rabeprazole and ranitidine bismuth citrate is safe and effective in eradicating Hp infection. It is worthy further observing.

关 键 词：螺杆菌 幽门 雷尼替丁枸橼酸铋 雷贝拉唑 

分 类 号：R573[医药卫生—消化系统]