两种三联法治疗十二指肠溃疡并幽门螺杆菌感染的对比研究

Comparative reach on two kinds of triple methods in the treatment of duodenal ulcer with helicobacter pylori infection

目的:评价埃索美拉唑、阿莫西林、左氧氟沙星及埃索美拉唑、克拉霉素、左氧氟沙星两种三联法7d疗程根除十二指肠球部溃疡合并幽门螺杆菌感染的疗效。方法:将92例经电子胃镜诊断为十二指肠球部溃疡、14碳-尿素呼气试验(14C-UBT)Hp阳性患者随机分为两组,即治疗组48例给予埃索美拉唑20mg、阿莫西林1000mg、左氧氟沙星200mg口服,2次/d,共7d;对照组44例给予埃索美拉唑20mg、克拉霉素500mg、左氧氟沙星200mg口服,2次/d,共7d;停服药4周后复查胃镜及14碳-尿素呼气试验,观察溃疡愈合情况以及幽门螺杆菌根除率。结果:治疗组及对照组幽门螺杆菌根除率及十二指肠球部溃疡愈合率分别为93.75%、93.18%和97.92%、97.73%,差异均无统计学意义(P>0.05)。结论:两种新的三联法治疗方案在治疗十二指肠球部溃疡并Hp感染均有效,不但为探讨多种根除Hp治疗方式提供了临床依据,同时可作为根除十二指肠溃疡Hp再感染复发的一线治疗或失败后的补救治疗方案。

Objective： Evaluated two kinds of seven-day triple therapy of esomeprazole,amoxicillin,levofloxacin,and esomeprazole,clarithromycin and levofloxacin to eradication Helicobacter pylori （Hp） with duodenal ulcer. Methods： The 92 cases of duodenal ulcer diagnosed by electronic gastroscope and 14 C-urea breath test （14C-UBT） were randomly divided into two groups,the treatment group （48 cases） for esomeprazole 20 mg,amoxicillin 1 000 mg,levofloxacin 200 mg orally,2 times a day, 7 days;the control group （44 cases） for esomeprazole 20 mg,clarithromycin 500 mg,levofloxacin 200 mg orally,two times a day,seven days.Four weeks after stopping medication the ulcer healing and Helicobacter pylori eradication rate were observed by reviewing endoscopy and 14 C-urea breath test. Results： Hp eradication rate and duodenal ulcer healing rate in the treatment group and control group were respectively 93.75%, 93.18% and 97.92%,97.73%,showing no significant differerence（P〉0.05）. Conclusion： Two new triple therapy methods in the treatment of duodenal ulcer with Hp infection were effective,not only provided clinical basis to explore a variety of Hp eradication treatment,but also could be as a first-line treatment while Hp re-infection after the eradication of Hp in duodenal ulcer or be as a remedial treatment program while the failure of Hp eradication.