低剂量三联疗法根除幽门螺杆菌作用及副反应的临床研究  

EFFICACY AND SIDE EFFECTS OF LOW DOSAGE TRIPLE THERAPY FOR THE ERADICATION OF HELICOBACTER PYLORI IN DUODENAL ULCER PATIENTS

作　　者：胡品津[1] 崔毅[1] 骆峰[1] 邓会芬[1] 陈旻湖[1] 

机构地区：[1]中山医科大学一院消化内科

出　　处：《中华消化杂志》1995年第S1期25-27,共3页Chinese Journal of Digestion

摘　　要：１２１例经尿素酶试验、组织学及细菌培养证实为幽门螺杆菌（Ｈｐ）感染的活动性十二指肠溃疡患者接受胶体次枸橼酸铋（德诺，ＣＢＳ）１２０毫克．四环素０．２５克及甲硝唑０．２克同服，每日４次共１４天。ＣＢＳ２４０毫克每日２次再服１４天。于停药１２周时用１４Ｃ－尿素呼吸试验、尿素酶试验、组织学及细菌培养鉴定Ｈｐ根除。其中９７例在治疗前进行甲硝唑耐药性检测。结果：Ｈｐ根除率为８６．０％（１０４／１２１）；副反应无、轻、中、重分别为８０．２％、１７．３％、２．５％和０％，敏感菌株根除率为９５．８％（６８／７１），耐药株为６５．３％（７／２６）。研究证明本方案根除率高，耐受性好，但必须注意甲硝唑耐药性对疗效的影响。One hundred and twenty-one patients with active duodenal ulcer and Helicobacter pylori infection proved by histology,urease test and culture(at least two out of three were positive) were treated with CBS(coloidal bismuth subcitrate) 120mg,tetracycline 250mg and metronidazole 200mg four times daily (after meals and before sleep) for a 14 day-course and only CBS 240mg twice daily for a further14 days.In 97 out of 121 patients,pretreatment metronidazole susceptibility was determined.Helicobacter pylori eradication was determined by14C-urea breath test,histology,urease test and culture (all were negative)at 12 weeks after cessation of treatment.side effects of the treatment were categorized into none,mild,moderate or severe.Eradication rate was achieved in 104 of 121 patients (86.0%),in 68 of 71 Patients with metronidazole-sensitive strain (95.8%),and in 17 of 26 patients with metronidazole-resistant strain (65.3%),80.2% of the patients experienced no side effect;17.3% had mild;2.5% had moderate and no case (0%) had severe side effect.Conclusion:(1)thistreatment regain is well tolerated and very effective for the eradication of metronidazole-sensitive H.pylon strain.(2) metronidazole-resistant strains are rat her common in China (27%),eradication rate by this treatment regimen is about 30% lower in resistant strains than in sensitive ones,but still being more effective as compared with other treatment regimens.

关 键 词：幽门螺杆菌 药物治疗 胶体次枸橼酸铋 甲硝唑 耐药性 

分 类 号：R573.05[医药卫生—消化系统]