四联疗法治疗幽门螺杆菌阳性十二指肠球部溃疡疗效观察

Curative Effect of Quadruple Chemotherapy in Treating Helicobacter Pylori-positive Duodenal Bulbar Ulcer

目的观察含雷贝拉唑的四联4日疗法根除幽门螺杆菌（Hp）的效果及其治疗Hp阳性十二指肠球部溃疡的疗效。方法选择120例Hp阳性十二指肠球部溃疡患者，将其随机分为治疗组和对照组，各60例。治疗组口服雷贝拉唑10mg／次，雷尼替丁枸橼酸铋（RBC）350mg／次，阿莫西林1000mg／次，呋喃唑酮100mg／次，均2次／d，共4d。对照组1：2服奥美拉唑20mg／次，阿莫西林1000mg／次，克拉霉素500mg／次，均2次／d，共7d。抗Hp治疗后继续服用雷贝拉唑10mg／次或奥美拉唑20mg／次，1次／d，疗程2周。观察治疗后4～6周时的Hp根除率、溃疡愈合率及随访半年、1年时的溃疡复发率和Hp再感染率。结果治疗后4—6周，治疗组和对照组渍疡愈合率分剐为98．2％和93．1％，差异无统计学意义（P〉0．05）；Hp根除率分别为96．4％和77．6％，差异有统计学意义（P〈0．01）。治疗组和对照组随访半年溃疡复发率分剐为3．8％和15．7％，随访1年分别为5．9％和20．0％，差异均有统计学意义（P〈0．05）；随访半年Hp再感染率分别为7．5％和21．6％，随访1年分别为11．8％和28．0％，差异均有统计学意义（P〈0．05）。结论含雷贝拉唑和RBC的四联4日疗法是一种短程、高效、安全的根除Hp和促进溃疡愈合的方法。

Objective To observe the effects of the quadruple chemotherapy including rabeprazole on Helicobacter pyloft （Hp） and on Hp -positive duodenal bulbar ulcer. Methods One hundred and twenty patients with Hp -positive duodenal bulbar ulcer were randomized into groups therapy and control, 60 in each. Therapy group received oral rabeprazole （ 10 mg/ times） , ranitidine bismuth citrate （RBC, 350 mg/times） , amoxicillin （ 1 000 mg/times） , furazolidone （ 100 mg/times）, twice/d, 4 d altogether. Control group received oral omeprazole （20 mg/times）, amoxicillin （ 1 000 rag/times）, clarithromycin （500 mg/times）, twice/d, 7 d altogether. After anti -Hp treatment, rabeprazele （10 mg/times） or omeprazol （20 mg/ times） was continuously used, once/d, 2 weeks. The Hperadication rate and ulcer healing rate 4 -6 weeks after treatment, and ulcer relapse rate and Hp reinfection after six - month or 1 - year follow up were observed. Results The ulcer healing rates of groups therapy and control were 98. 2%, 93.1%, respectively, 4 -6 weeks after treatment, the difference was not significant （P 〉0. 05）, and the Hp eradication rates were 96. 4%, 77. 6%, respectively, the difference was significant （P 〈0.01 ）. The ulcer relapse rates were 3.8% , 15.7% , respectively, after 6 - month follow up, and 5.9% , 20. 0% , respectively, after 12 -month follow up, the difference was significant （P 〈0. 05）. Hp re -infection rates were 7. 5% , 21.6% , respectively, after 6 - month follow up, and 11.8%, 28.0% , respectively, after 12 - month follow up, the difference was significant （P 〈 0. 05）. Conclusion The 4 - day quadruple chemotherapy of combined rabeprazole and RBC is a short - range, efficient and safe method in Hp eradication and ulcer healing promotion.