140例幽门螺杆菌相关性消化性溃疡的治疗与随访

Treatment and Follow-up of Peptic Ulcer inCorrelation with Hellcobactor Pylor (AnalysisOf 140 cases)

笔者收集了经内镇证实伴幽门螺杆菌（ＨＰ）感染的消化性溃疡１４０例。随机分为三组，分别使用呋喃唑酮＋得乐冲剂＋雷尼替丁（Ｆ＋ＣＢＳ＋Ｒ组），呋喃唑酮＋得乐冲剂（Ｆ＋ＣＢＳ组），及单用雷尼替丁（Ｒ组）．疗程４周，维持治疗４周。通过近期及一年的随访的治疗效果，其溃疡４周治愈率以Ｆ＋ＣＢＳ＋Ｒ组最高（９７．６％，８２／８４），显著高于Ｆ＋ＣＢＳ组（７５％，２７／３６）和Ｒ组（７０％，１４／２０）（Ｐ＜０．０１）．ＨＰ消失率和胃粘膜炎症病理好转主是Ｆ＋ＣＢＳ＋Ｒ组（８１％，５２．４％）和Ｆ＋ＣＢＳ组（８０．６％，５２．８％）显著高于Ｒ组（５％，１０％）（Ｐ＜０．００１）．停药一年随访结果，溃疡复发率是Ｆ＋ＣＢＳ＋Ｒ组（１３．１％，１１／８４）和Ｆ＋ＣＢＳ组（１５．２％，５／３３）显著低于Ｒ组（１６．７％，１２／１８）（Ｐ＜０．００１）；ＨＰ根除率与溃疡复发率相对应，前两组（８３．８％，８２．８％）明显高于Ｒ组（Ｐ＜０．００１）．作者认为联合使用清除ＨＰ药物（Ｆ，ＣＢＳ）、制酸药物（Ｈ２受体拮抗剂）和胃粘膜保护剂（ＣＢＳ），不仅可有效地提高消化性质疡的近期疗效，而且可以显著降低其复发率。

Abstract140 patients with peptic ulcer infected byhelicobacter pylor (HP) were divided into 3groups randomlly. The treatment lasted 4weeks. The cure rate of ulcer, in the grouptreated with furazolidoni, CBS and ranitidine(97. 6% , 82/84) , was much higher than thatin the group with furazolidoni and CBS (75 % ,27/36) , and in the group with ranitidine only(70% , 14/20) (P<0. 01). The clearance rateof HP and histopathological improvement rateof gastric mucosa in the F +CBS +R group( 81% , 52. 4 %) . and in the F + CBS group(80. 6%, 52. 8%), were much higher thanthat in the R group (5% , 10%) (P<0. 001)After one year, of withdrawing of thedrufs the recurrent rates in the F +CBS + Rgroup (13. 1% . 71/84 ) and F+ CBS group( 15. 2% , 5/33) were much lower than that inthe R group (66. 7%, 12/18) (P<0. 001).The clearance rates of HP, in the F+CBS+ R group (83. 8%, 57/68) and F+CBSgroup (82. 8% , 24/29), were much higherthan that in the R group (PMO< 001)The authors suggest that the use of fura-zolidoni, CBS and ranrtidine in conibinationmay increase the shortterm effect in pepticulcer and decrease the recurrent rate.KE Y WORDS helicobacter pylor (HP)peptic ulcer endoscopy