埃索美拉唑三联疗法不同疗程治疗幽门螺杆菌阳性活动期十二指肠溃疡的疗效观察

Different courses of esomeprazole triple therapy on the treatment of Helicobacter pylori-positive active duodenal ulcer

目的观察埃索美拉唑三联疗法不同疗程治疗幽门螺杆菌(Hp)阳性的活动期十二指肠溃疡的疗效及安全性。方法 80例经胃镜证实Hp阳性的活动期十二指肠球部溃疡患者,随机分成1周疗法组(A组)和2周疗法组(B组)。A、B2组用药均为埃索美拉唑20mg、阿莫西林1.0g、克拉霉素缓释片0.5g,均每天2次。A组疗程1周,B组疗程2周。治疗过程中观察不良反应发生情况,停药4周后复查胃镜,观察溃疡愈合率,并作14C尿素呼气试验(14C-UBT)了解Hp根除率。结果 A组溃疡愈合率、Hp根除率、不良反应发生率分别为91.9%、77.5%、5.0%;B组分别为92.1%、90.0%、5.0%。A、B2组之间比较Hp根除率差异有统计学意义(P<0.05);溃疡愈合率、不良反应发生率差异无统计学意义(P>0.05)。结论埃索美拉唑+阿莫西林+克拉霉素三联2周疗法治疗Hp阳性的活动期十二指肠溃疡,可达到满意的Hp根除率和溃疡愈合率,且不良反应小。

Objective To observe the curative effect of esomeprazole plus clarithromycin sustained-release tablets and amoxicillin 1 week or 2 week term triple therapy for active duodenal ulcer with positive helicobacter pylori（Hp）.Methods 80 cases of active duodenal ulcer patients with Hp infection were randomly divided into two groups.Group A（n=40） was administrated with esomeprazole 20mg plus clarithromycin sustained-release tablets 500mg and amoxicillin 1000mg for 7 days,two times a day,while group B（n=40） for 14 days.Hp was tested and endoscopy was checked after four weeks.Results The Hp eradication rate,active ulcer healing rate and the incidence of adverse reactions was 91.9%,77.5%,5.0% in group A and 92.1%,90.0%,5.0% in group B.Comparision between A,B groups,the difference of Hp eradication rate was significant（P0.05）,while the ulcer healing rate and incidence of adverse reactions was no significant difference（P0.05）.Conclusion The method using esomeprazole plus clarithromycin sustained-release tablets and amoxicillm for two weeks was very good to eradicate the infection of Hp and heal ulcer,the incidence of adverse reactions was low.