雷贝拉唑为基础的五日疗法治疗幽门螺杆菌感染的疗效观察

Five-day rabeprazole-based triple therapy for helicobacter pylori infection

目的 :观察以雷贝拉唑为基础的短程 5d疗法治疗幽门螺杆菌 (H .pylori)感染的疗效 ,了解雷贝拉唑、克拉霉素及呋喃唑酮联合用药能否解决近年来H .pylori根除率下降的问题。方法 :95例伴幽门螺杆菌感染的消化性溃疡及糜烂性胃炎患者 ,随机分为 2组 ,选用雷贝拉唑 10mg、克拉霉素 5 0 0mg及呋喃唑酮 10 0mg ,均为每天 2次口服 ,进行 5d疗法 (5dRCF组 )与 7d疗法 (7dRCF组 )对照观察 ,用药结束后 2 8d复查胃镜、14 C呼气试验及病理检查 ,了解 2组H .pylori根除率、药物副作用及溃疡愈合情况。结果 :H .pylori根除率 ,(1)ITT分析 :5dRCF组为77.8% ,7dRCF组 82 % (P >0 .2 5 ) ;(2 )PP分析 :5dRCF组为 94 .4 % ,7dRCF组为 97.6 % (P >0 .5 )。 2组副作用均少见 ,继续服药不影响治疗。溃疡及糜烂愈合情况 ,5dRCF组为 97.6 % ,7dRCF组为 97.8% (P >0 .2 5 )。结论 :以雷贝拉唑为基础的联合克拉霉素及呋喃唑酮的短程 5d疗法治疗幽门螺杆菌感染的疗效确定 ,根除率高 ,副作用小 ,进一步提高了抗H .pylori治疗的依从性 ,是有前途的根除H .

Objective To evaluate the efficacy of a 5-day rabeprazole-based triple therapy regimen for helicobacter pylori infection, and to improve the eradication rates of antibiotic-resistant Helicobacter pylori with rabeprazole plus clarithromycin and furazolidone. Methods We selected 95 H.pylori-positive patients with gastric or duodenal ulcers or erosive gastritis and randomized them into 2 groups. The patients were given a 7-day triple standard therapy and 5-day triple standard therapy, consisting of rabeprazole 10 mg twice daily,clarithromycin 500 mg twice daily and furazolidone 100 mg twice daily. H.pylori status was checked by rapid urease test or 14C urea breath test and histology before and 4 weeks after the therapy. Results The eradication rate of H.pylori for patients under the 5-day treatment vs.7-day treatment were 77.8% vs.82% by per protocol and 94.4% vs.97.6% by intention to treat analysis(no significant comparisons). The ulcer and erosion healing rate was 97.6% vs. 97.8%(no significant comparisons).No major side-effects were reported.Conclusion The 5-day rabeprazole-based triple therapy(combined with clarithromycin and furazolidone) for helicobacter pylori infection is an effective regimen with excellent patient acceptability and compliance.