以埃索美拉唑为基础的四联疗法根除幽门螺杆菌及治疗消化性溃疡的探讨

Study of Esomeprazole Based Quadruple Therapy for Helicobacter Pylori Infection and Peptic Ulcer

目的探讨中短程以埃索美拉唑为基础的四联疗法根除幽门螺杆菌(Hp)和治疗消化性溃疡的效果。方法103例慢性胃炎和Hp相关性溃疡患者被分为2组分别给予埃索美拉唑+次枸橼酸铋钾+克拉霉素+替硝唑(四联)1周(A组,51例)和2周(B组,52例),所有溃疡病患者再以埃索美拉唑20mgbid维持治疗7周(A组)或6周(B组),3个月后复查胃镜并进行Hp14碳-呼气试验(14C-UBT)检查。结果四联1周法的Hp根除率为94.1%,溃疡治愈率为94.6%,四联2周法Hp根除率和溃疡治愈率分别为96.2%和95.2%,P>0.05,2组中未出现明显副作用。结论埃索美拉唑能显著提高Hp根除率和溃疡愈合率,以埃索美拉唑为基础的一周四联疗法具有根除Hp时间短、方便、安全的优点,值得推广应用。

Objective To evaluate the efficacy of 1 week and 2 week esomeprazole-based quadruple therapy on H. pylori infection and peptic ulcer. Methods One hundred and three patients with H. pylori infection were randomized to either 1 week of EBCT（ esomeprazole 20 mg bid ,bibismuth subcitrate 220 mg bid ,claithromycin 0. 25 g bid and tinidazole 0. 5g bid group A ,51 cases of chronic gastritis and peptic ulcer） or 2 week of EBCT（ esomeprazole 20 mg bid, bibismuth subcitrate 220 mg bid, claithromycon 0. 25 g bid and tinidazole 0. 5 g bid group B ,52 cases of chronic gastritis and peptic ulcer）. After eradicating Helicobacter pylori the patients of group A and group B were administerded esomeprazole 20 mg bid for 7 or 6 weeks respectively, ^14 C-urea breath test and gastroscope were performed at week 12 to assess post-treatment H. pylori and ulcer status. Results H. pylori eradication was achieved in 48 of 51 （94. 1% ） subjects in group A and 50 of 52（96. 2% ） subjects in that of group B, respectively, P 〉 0.05. Ulcer cure rates of groups A and group B were 94. 6% and 95.2% , respectively, P 〉 0.05. There were not any severe side effects in all two groups. Conclusion 1 week esomeprazole-based quadruple therapy（ EBCT, esomeprazole 20 mg bid,bibisumth subcitrate 220 mg bid,claithromycin 0. 25g bid and tinidazole 0.5g bid） was effective and safe for H. pylori infection and peptic ulcer.