果胶铋三联与四联疗法治疗幽门螺杆菌阳性消化性溃疡的疗效比较  

Comparison of therapeutic efficacy of pectin bismuth triple and quadruple therapy on Helicobacter pylori positive peptic ulcer

作　　者：陈睿[1] 季玲玲[1] 叶希平[1] 曹彬[1] 

机构地区：[1]安徽省铜陵市第四人民医院内科,244000

出　　处：《蚌埠医学院学报》2014年第2期207-208,211,共3页Journal of Bengbu Medical College

摘　　要：目的:比较果胶铋三联和四联疗法治疗幽门螺旋杆菌(Hp)阳性的消化性溃疡的疗效。方法:经电子胃镜和快速尿素酶方法确诊的Hp阳性胃溃疡和十二指肠溃疡共125例,按治疗方法分为2组,三联疗法组60例:果胶铋0.2 g 3次/日,克拉霉素0.5 g 2次/日,甲硝唑0.4 g,2次/日,1疗程为2周;四联疗法组:果胶铋、甲硝唑、克拉霉素用法用量同三联疗法,加用雷贝拉唑20 mg,2次/日,1个疗程为1周。疗程结束4周后行电子胃镜及快速尿素酶试验复检。结果:125例均获随访,四联疗法组总有效率高于三联疗法组(P<0.05),症状缓解时间较三联疗法组短(P<0.01),不良反应发生率低于三联疗法组(P<0.05),Hp根除率与三联疗法差异无统计学意义(P>0.05)。结论:含雷贝拉唑的四联疗法治疗Hp阳性的胃溃疡、十二指肠溃疡,其症状缓解时间、溃疡愈合,不良反应等方面优于三联疗法。Objective：To compare the effects of pectin bismuth triple and quadruple therapy in the treatment of Helicobacter pylori （kip） positive gastric ulcer and duodenal ulcer. Methods：One hundred and twenty-five cases of Hp-positive gastric ulcer and duodenal ulcer were confirmed byelectronic endoscopy and rapid urease test. The triple therapy group received bismuth pectin 0.2 g,3 times a day, clarithromycin 0. 5 g plus metronidazole0. 4 g twice a day for two weeks ; the quadruple therapy group were administered bismuth pectin 0. 2 g,3 times a day,clarithromycin 0.5 g plus metronid azole 0.4 g and rabeprazole azole 20 mg twice a day for one week. Four weeks later, the eradication rate of the Hp and the healing rate of the peptic ulcer were evaluated according to the results of the repeated electronic endoscopy and the rapid urease test. Results：One hundred and twenty-five cases were followed up. The total effective rate of the quadruple therapy was higher than that of the triple therapy（P 〈 0.05） ;the quadruple therapy was superior to the triple therapy in relieving the pain （P 〈 0. 01 ） ;there was less incidence of adverse reactions in the quadruple therapy group than the triple therapy group （P 〈 0. 05） ; there was no statistical difference in the Hp eradication rate between the quadruple therapy group and the triple therapy group（P 〉 0.05 ）. Conclusions ：The quadruple therapy containing rabeprazole is superior to the triple therapy in the time of pain relief, ulcer healing and incidence of adverse reactions in treatment of Hp-positive gastric ulcer and duodenal ulcer.

关 键 词：胃溃疡 十二指肠溃疡 幽门螺杆菌 药物疗法 联合 

分 类 号：R573.1[医药卫生—消化系统]