三联短程疗法治疗幽门螺杆菌阳性十二指肠溃疡的随访研究  

Follow -upstudy of triply short therapy for the treatment of duodenal ulcer with H .pylori infection

作　　者：贾建忠 雷小红 陈中青 白玉萍 

机构地区：[1]武警宁夏总队医院,宁夏银川750004

出　　处：《宁夏医学杂志》2000年第12期729-730,共2页Ningxia Medical Journal

摘　　要：目的　探讨奥美拉唑 (Omeprazole)、羟氨苄青霉素 (Amoxycillinum)和甲硝唑 (Metronidazole)一周短程疗法根除幽门螺杆菌 (Hp)的疗效 ,对Hp相关性活动期十二指肠溃疡 (DU)治疗效果和复发的影响 ,并与两周疗法相比较。方法　将 12 8例Hp阳性的活动期DU患者随机分成两组 ,A组 :奥美拉唑 2 0mg、羟氨苄青霉素 10 0 0mg、甲硝唑40 0mg ,每日 2次 ,共 1周 ,奥美拉唑 2 0mg,每日 1次 ,共 4周 ;B组 :奥美拉唑 2 0mg、羟氨苄青霉素 10 0 0mg、甲硝唑40 0mg ,每日 2次 ,共 2周 ,奥美拉唑 2 0mg ,每日 1次 ,共 4周。治疗前和治疗后 1月、1年各做 1次电子胃镜检查 ,并取活组织做快速尿素酶和Warthin -Starry银染色检查Hp。结果　A、B两组Hp根除率分别为 92 19% (5 9/ 6 4)、95 31% (6 1/ 6 4) (P >0 0 5 ) ;DU治愈率 93 76 % (6 0 / 6 4) ,96 88% (6 2 / 6 4) (P >0 0 5 ) ;副作用发生率 4 6 9% (3/ 6 4)、12 5 0 % (8/ 6 4) (P <0 0 1)。Hp根除与否 1年后DU复发率 3 33% (4 / 12 0 )、75 0 0 % (6 / 8) ,(P <0 0 1)。结论　以奥美拉唑为主 ,合并羟氨苄青霉素和甲硝唑治疗Hp相关性DU、Hp清除率和DU治愈率高 ,并能有效预防DU复发。 1周短程疗法即可达到治疗目的 ,副作用小 ,顺应性好 ,可以取代 2周疗法 。objectives Toevaluateanewtripleshorttherapywithomeprazole ,amoxycillinumandmetronidazole .Methods Onehundredandtwen tyeightpatientswithhelicobacterpylori(Hp)positivemovabilityduodenalulcer(DU)wererandomisedintotwogroups.GroupsA (n =64)receivedomeprazole 2 0mgbid ,amoxycillinum 1 0 0 0mgbidandmetronidazole 40 0mgbidforoneweek ,continuousgivedomeprazole 2 0mgdailyforforthweeks.GroupsB (n =64) recievedomeprazole 2 0mgbid ,amoxycillinum 1 0 0 0mgbidandmetronidazole 40 0mgbidfortwoweeks,continuousgivedomeprazole 2 0mgdailyforforgh weeks.Edoscopicexaminationwascarriedbeforetreatmentandonemonth ,twelvemonthsaftercessationofthetreatment.TheHpstatuswasdiagnosesbyrapid ureasetestandWathin -StarryStainhistological.Results HperadicationrateofAandBtwogroupswas92 .1 9% (59/ 64)and 95 .31 % (61 / 64)respectively . ThecurerateofDUwas 93 .75 % (60 / 64)and 96 .88% (62 / 64)respectively .Therewasnostatisticalsignificantdifferencebetweenthetwogroupsfortheabove results(P >0 .0 5) .Theadversedrugreactionrateoftwogroupswas4 .67% (3/ 64)and 1 2 50 % (8/ 64)respectively(P <0 .0 1 ) .TheHpwasweathereradica tionornot,thecurerateofDUwas 98.33 % (1 1 8/ 1 2 0 )and 62 .50 % (5/ 8)respectively ;Oneyearlater,theDUhavearelapserateinthetwogroupswas 3 .33 % (4/ 1 2 0 )and 75 .0 0 % (6/ 8)respectively(P <0 .0 1 ) ,therebeingasignificantdifferencebetweenthetwogroups .Conclusions Oneweekshottripletherapy withomeprazole ,amoxycillinumandmetronidazoleishighlyeffective ,well-toleratedandsafeforeradicationofHpinfection ,andhighlycurerateofDU ,the eradicationofwhichisassociatedwithasignificantreductionintherateofDUrecurrenceandoccurrence.

关 键 词：幽门螺杆菌 十二指肠溃疡 三联短程疗法 

分 类 号：R573.105[医药卫生—消化系统]