抑酸和抗Hp疗法治疗十二指肠溃疡的前瞻性对照研究

The prospective study on antiacid and anti-Hp for duodenal ulcer

目的探讨幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｌｏｒｉ，Ｈｐ）与十二指肠溃疡复发率的关系．方法３６例ＨＰ相关性十二指肠溃疡，随机分为３组：Ⅰ组（洛赛克组），１３例；Ⅱ组（得乐十甲硝吹＋四环素组），１１例；Ⅲ组（雷尼替丁组），１０例。疗程４Ｗｋ，内镜检查和活检以及ＨＰ检查（尿素酶试验及ＷＳ染色）观察２ａ溃疡累计复发率及ＨＰ阳性率。结果Ⅰ、Ⅱ、Ⅲ组２年累计复发率分别为６９２％、７２７％和２００％，Ⅲ组明显低于Ⅰ、Ⅱ组（Ｐ＜０．０１）。Ⅰ组与Ⅱ组相似（Ｐ＞０．０５）。治疗２ａ后胃粘膜ＨＰ阳性率Ⅰ、Ⅱ、Ⅲ组分别为８４６％、７２．７％和９００％。结论治疗２ａ后雷尼替了组胃粘膜ＨＰ阳性率明显高于洛赛克组和得乐十甲硝唑＋四环素组，前者２ａ累计复发率却明显低于后２组，提示ＨＰ的存在并未增加溃疡复发率。

Objective To study the relationship between Helicobacter Pylon (HP) and recurrence rate of duodenal ulcer.Methods Thirty-six patients with Hp-associated duodenal ulcer were randomly divided into 3 groups: group Ⅰ,13 patients received losec;groupⅡ,11Patients, tripotassium dicitrato bismuthate (TDB) and metronidazolum +Tetracyclinum; groupⅢ, 10 patients received ranitidine. Endoscopy and biopsy were performed in all patients. Hp was examined by urease test and Warthin-Starry stain before treatment and at 24 months since treatment. Results The cummulative recurrence rates of groupⅠ. Ⅱ' Ⅲ were 69.2%.72.7 %. and 20.0% respectively, the rates of groupⅢ were significantly less than other two groups (P< 0.01) .There were no difference between group Ⅰ and groupⅡ. The rates of Hp-positive in group Ⅰ.Ⅱ. Ⅲ were 84.6%, 72.7% and 90.0%respectively at 24 months sincetreatment. The rates of Hp-positive in group Ⅲ were significantly more thangroup Ⅰ.Ⅱ (p<0.05).Conclusion The exist of Hp didn't lead to increase the recurrence of duodenal ulcer.