雷贝拉唑、克拉霉素、阿莫西林三联疗法治疗幽门螺杆菌相关性溃疡

Rabeprazole combined with clarithromycin and amoxicillin in the treatment of Helicobacter pylori-related ulcer

目的:评估雷贝拉唑、克拉霉素、阿莫西林三联疗法治疗幽门螺杆菌(Helicobacter pylori,Hp)相关性溃疡的疗效。方法:86例经胃镜检查确诊,并经快速尿素酶法和组织学测定为Hp阳性的消化性溃疡病人,随机分为雷贝拉唑组(46例)和奥美拉唑组(40例)。两组分别予以三联疗法:雷贝拉唑20 mg或奥美拉唑20 mg,bid;克拉霉素0.5 g,bid;阿莫西林1.0 g,bid,连用10 d,记录用药后病人症状缓解程度。疗程结束后4周,复查胃镜并检测Hp。结果:雷贝拉唑组第1、3天症状缓解率分别为65.2%和93.5%;奥美拉唑组为20.0%和45.0%,两组差异有显著性(P<0.05)。雷贝拉唑组溃疡治愈率为95.7%,奥美拉唑组为72.5%,两组比较差异有显著性(P<0.05)。雷贝拉唑组Hp根除率为93.5%,奥美拉唑组为90.0%,两组比较无统计学差异(P>0.05)。结论:雷贝拉唑三联疗法治疗Hp相关性溃疡,溃疡愈合迅速、症状消失快,与奥美拉唑组比较,雷贝拉唑组在症状缓解率及溃疡愈合方面更具优势。

Objective：To evaluate the efficacy of rabeprazole combined with clarithromycin and amoxicillin in the treatment of Helicobacter pylori （Hp）-related ulcer. Methods：Eighty-six patients with peptic ulcer and Hp infection confirmed by gastroscopy and right urease test were randomized to receiving rabeprazole（46 cases）- or omeprazole（40 cases）- based triple therapy regimen for 10 days. The therapeutic regimens were as follows： rabeprazole 20 mg or omeprazole 20 mg, bid; clarithromycin 0.5 g,bid;amoxicillin 1.0 g,bid. The patients＇ symptomatic relief rate after medication was recorded. Gastroscopy and right urease test were repeated in the fourth week after the end of the treatment. Results： On the first day and the third day of the treatment, the symptomatic relief rate was 65.2% and 93.5% in rabeprazole group.while it was 20.0% and 45.0% in omeprazole group. There were significant differences between the two groups（P〈0.05）. The ulcer healing ratc of rabeprazole group was higher than that of the omeprazole group（95.7% vs 72. 5%, P〈0. 05）. Hp eradicalion rale was 93.5% in rabeprazole group and 90.0% in omeprazole group. There was no significant difference between lhe l wo groups （P〉 0. 05 ）. Conclusion： Compared with the omeprazole group, rabeprazole group has better efficacy in ulcer healing and symptomatic relief rate.