十二指肠溃疡患者根除幽门螺杆菌后抑酸维持治疗的疗效研究  

Therapeutic Effect of Continuing Anti-secretory Treatment after Helicobacter pylori Eradication Therapy in Patients with Duodenal Ulcer

作　　者：傅丽霞[1] 罗鸣[1] 

机构地区：[1]浙江省丽水市中心医院消化内科,323000

出　　处：《胃肠病学》2012年第5期297-299,共3页Chinese Journal of Gastroenterology

摘　　要：背景:对感染幽门螺杆菌(H.pylori)的消化性溃疡患者成功根除H.pylori后,是否应继续行抑酸治疗,目前尚存在争议。目的:探讨合并H.pylori感染的十二指肠溃疡(DU)患者根除H.pylori后抑酸维持治疗的疗效。方法:112例合并H.pylori感染的DU患者随机分为A组和B组,A组给予10 d四联疗法:兰索拉唑30 mg+阿莫西林1 g+克拉霉素0.5g bid+枸橼酸铋钾110 mg qid,疗程10d。B组:在A组方案的基础上,疗程结束后再予兰索拉唑30 mg,1次/d,维持4周。治疗结束4周后复查胃镜,评估H.pylori根除疗效、溃疡愈合率和腹痛缓解率。结果:109例患者完成方案。A、B两组按意向治疗(ITT)和按方案(PP)分析的H.pylori根除率(ITT:85.7%对87.5%;PP:88.9%对89.1%)和溃疡愈合率(ITT:87.5%对94.6%;PP:90.7%对96.4%)以及腹痛缓解率(95.6%对95.7%)相比差异均无统计学意义(P>0.05)。结论:以10 d四联疗法根除H.pylori后,可使多数DU患者的溃疡愈合,无需进一步行维持抑酸治疗。Background： There is controvertial about the necessity of continuing anti-secretory treatment after Helicobacter pylori （ H. pylori） eradication therapy in patients with peptic ulcer. Aims： To investigate the therapeutic effect of continuing antisecretory treatment after H. pylori eradication therapy in patients with duodenal ulcer （DU）. Methods： One hundred and twelve patients with DU were randomly divided into group A and group B. Patients in group A were given 10-day quadruple therapy （lansoprazole 30 mg ＋ amoxicillin 1 g ＋ clarithromycin 0.5 g bid ＋ colloidal bismuth subcitrate 1 10 mg qid）. Patients in group B were given 10-day quadruple therapy followed by continuing anti-secretory treatment （lansoprazole 30 mg, once a day for 4 weeks）. Four weeks after the end of treatment, gastroscopy was reperformed, and H. pylori eradication rates, ulcer healing and abdominal pain relief rates were assessed. Results： A total of 109 patients completed the study. H. pylori eradication rates by intention-to-treat （ITT） and per-protocol （PP） analysis （ITT： 85.7% vs. 87.5% ; PP： 88.9% vs. 89.1% ）, ulcer healing rates by ITr and PP analysis （ITT： 87.5% vs. 94.6% ; PP： 90.7% vs. 96.4% ）, and abdominal pain relief rate （95.6% vs. 95.7% ） were not statistically different between group A and group B （P 〉 0.05 ）. Conclusions： After eradication of H. pylori by 10-day quadruple therapy, ulcer is healed in most of DU patients. Continuing anti-secretory treatment is not necessary.

关 键 词：十二指肠溃疡 螺杆菌 幽门 治疗 

分 类 号：R573.1[医药卫生—消化系统]