中国消化性溃疡治疗现状调查报告

The report on current status of peptic ulcer treatment in China

目的调查中国消化性溃疡治疗情况，为规范治疗提供资料。方法对2006年全国6个大区中27个省（市）300多家医院中经内镜证实的、符合人选标准的活动性消化性溃疡患者，由所在单位医师负责填写调查表格，主要内容包括病程、发病时间、受诊时间、幽门螺杆菌（Hp）感染、主要症状、药物治疗情况等。由专业公司电话随访，将汇总资料进行统计学分析。结果人组的10575例患者中，电话回访7610例，成功确认6035例。3998例为消化性溃疡患者（66．2％）。其中，十二指肠溃疡（DU）2395例，胃溃疡（GU）1603例，DU：Gu为1．49：1，男性65．5％，女性30．6％（资料缺失3．9％），40～60岁者占34．9％。消化性溃疡患者中，Hp感染阳性2039例（51．0％），接受HP根除治疗1015例（49．8％）；Hp阴性748例（18．7％），其中715例（95．6％）未作根除治疗；1211例（30.3％）未查Hp。Hp根除治疗方案中，以质子泵抑制剂（PPI）＋阿莫西林＋克拉霉素最多。治疗后症状改善3654例（93．9％）。PPI剂量通常为常规用量，疗程以1周最多。结论以PPI为基础的三联抗Hp治疗已成为中国溃疡病治疗的主要方法，可明显改善症状，不良反应小。因而规范消化性溃疡的治疗方案势在必行。

Objective To assess the overall peptic ulcer treatment in china, and provide information to establish a standard therapy. Methods Patients with active peptic ulcer diagnosed by endoscopic examination from more than three hundred hospitals in 27 provinces throughout China's Mainland were seclected, the physicians with the questionnaires about the natural history, the timing of onset of symptoms, the timing of receiving endoscopic examinations, the major symptoms and the medical treatment of every patients were surveyed. The patients were also followed with telephone communication by professional company. Results Total 10 573 individuals were enrolled in the investigation, and 7610 individuals could be contacted by telephone, 6035 patients were successfully followed up. Peptic ulcer accounted for the majority of these patients （66.2%, 3998/6035）, and there were 2395 cases of duodenal ulcer and 1603 cases of gastric ulcer, with 65.5% of male and 30.6% of female（3.9% data absence） , 34.9% of patients were between the age of 40-60. Among these 3998 patients, H pylori infections were identified in 2039 patients （51.0%）, subsequently, 1015 patients （49.8%） received H pylori eradication therapy and 715 patients were not treated. Seven hundreds and forty eight patients were negative for H pylori infection. One thousand two hundreds and eleven patients did not undergo any test for H pylori. Among the eradication therapies, the 1-week proton pump inhibitor （PPI）-based triple therapy （normal dosage PPI ＋ amoxicillin or clindamycin） was mostly prescribed. Symptom improvement was identified in 3154 patients （93.9%）. Conclusion The seven-day PPI-based triple therapy, which was associated with significant symptom improvement and few adverse events, was the treatment of choice for peptic ulcer in China. However, more efforts should be done to standardize the management of peptic ulcer in China.