短期三联疗法对幽门螺杆菌根治的效果

The clinical observation of short term triple therapy including proton pump inhibitor for H. pylori eradication treatment

目的:了解含有质子泵抑制剂(PPI)兰索拉唑的短期三联疗法对幽门螺杆菌(HP)根治的效果、不良反应及溃疡愈合和复发情况.方法:对152例胃镜证实为消化性溃疡患者,经胃粘膜活检脲素酶法(clo-test)测 定HP,阳性者用PPI兰索拉唑30mg bid,阿莫西林500mg bid及克拉霉素500 mg bid三联治疗7 d,分别于治疗结束后的4 wk及6 mo复查胃镜及clo-test,并记录根治治疗的不良反应.结果:152例消化性溃疡患者中.141例(92.8%)HP测定阳性,治疗后4 Wk复查时,HP根治率为95.5%,溃疡愈合率为92.2%,3%的病人出现轻度不良反应,且不影响治疗.治疗后6mo复查,HP阴性率为93.0%,溃疡复发率为2.6%,且复发者HP测定均再次阳性.结论:短期三联HP根治疗法具有疗效高,不良反应小,耐受性好等优点.

AIM :To evaluate the effect of short term triple therapy including proton pump inhibitor (PPI) for H. pylori (HP) eradication treatment. METHODS :Clo-tests for HP detec-tion were applied in 152 patients with peptic ulcer disease. HP eradication treatment was gi-ven to patients with positive clo-test. The treatment included lansoprazole,which was named proton pump inhibitor,30 mg bid,amoxicillin 500 mg bid and clarithromycin 500 mg bid for 7 d. We followed up the endoscopy and clo-test in patients who were given HP eradication treatment 4 wk and 6 mo after the treatment was finished. RESULTS:In 152 patients with peptic ulcer disease, 141 (92. 8%) were positive clo-test. Eradication rate and ulcer healing rate were 95. 5% and 92. 2% 4 wk after eradication treatment. Occurrence rate of side effects was 3%. The side effects were slight and did not affect the eradication treatment. 93. 0% of the patients were negative clo-test and only 3(2. 6%)patients who had positive clo-test again were found recurrence of peptic ulcer 6 mo after eradication treatment. CONCLUSION:Short term triple therapy including PPI has consistently high eradication rate, high ulcer healing rate and good compliance of the patients.