维敏四联治疗Hp相关的消化性溃疡

Quadruple therapy with weimin for Hp-positive peptic ulcer

目的应用维敏胶囊（胶态果胶铋）四联药物疗法治疗Hp相关的消化性溃疡（PU）2wk，停药4wk后经内镜、14C-UBT等方法观察溃疡的愈合及Hp根除的疗效方法经内镜确诊为PU，其中十二指肠溃疡（DU）169例；胃溃疡（GU）89例．受检前2wk内未服抗生素、铋剂及质子泵阻断剂，排除孕妇和溃疡出血者，并镜下活检病理排除恶性溃疡Hp检测：先行快速尿素酶检测（RUT），阳性者再行14C-UBT检测，其中DU的Hp阳性率为95．5％；GU的Hp阳性率为81．0％．四联治疗方法：对Hp阳性PU，给予维敏胶囊100mg，4次／d；兰索拉唑30mg，2次／d；阿莫西林0．5g，4次／d；甲硝唑0．4g，2次／d，疗程为2wk．停药后4wk，同时复查内镜及14G-UBT．结果DU愈合率91．2％，Hp根除率93．0％；GU愈合率86．0％，Hp根除率92．0％．DU和GU愈合率及Hp根除率差异不明显（P＞0．05）；四联疗法后肝肾功能无异常结论Hp与PU关系密切．采用四联治疗Hp相关的PU，有良好效果．14GUBT检测Hp感染具有很高的敏感性和特异性，无创伤性。

AIM To study the effect of quedruple therapy with weimin in treatret Of Hp+ peptic ulcer.METHODS Gastroscopically confirmed peptic ulcer patients (DU, duodenal ulcer 169; GU, gastric ulcer 89,maligunt GU was depteted by pethological examination)were tested with Hp (first with RUT, if positive with 14C-UBT). The positive rate of Hp in DU was 95.5%; in GU 81.0%. The treatment methods: weimin 100mg, four times a day; lansoprazole 30 mg, twice a day; amoxycillin 0.5g, four times a day; metronidazole 0.4 g, twice a day,for 2 weeks. Then 4 weeks later all patients were examineted with gastroscope and 14CUBT.RESULTS Curative rate of DU was 91.2% and GU 86.0%, Hp eradication rate in DU was 93.0% and in GU 92.0%, without significent difference statistically (P>0 .05) between DU and GU. Liver and renal functions were normal after treatment.CONCLUSION We has a close relation with peptic ulcer.The quadruple treatment with weimin-lansoprazoleamoxycillin-metronidazole for peptic ulcer is significantly effective. Meantime the 14C-UBT examination for peptic ulcer with Hp is very sensitive and specific.