根除幽门螺杆菌对功能性消化不良疗效的研究

Effect of Helicobacter pylori Eradication on Functional Dyspepsia

背景:功能性消化不良(FD)的患病率始终居高不下,目前就幽门螺杆菌(H.pylori)阳性的FD患者是否需根除H.pylori尚存在争议。目的:探讨根除H.pylori对H.pylori阳性FD患者的疗效。方法:200例H.pylori阳性FD患者随机分为治疗组(100例.予以枸橼酸铋雷尼替丁400mg+阿莫西林1000mg+克拉霉素250mg,2次/d,疗程1周)和对照组(100例,予以铝碳酸镁1000mg,3次/d,疗程1周)。随访结束后评估H.pylori根除率和FD症状改善情况。结果:治疗组的H.pylori根除率分别为87.5%(PP分析)和84.0%(ITT分析),对照组H.pylori根除率为0%。H.pylori根除亚组FD症状改善的总有效率显著高于H.pylori未根除亚组和对照组(90.5%对41.7%和45.9%,P<0.01)。结论:部分H.pylori阳性FD患者根除H.pylori后,其症状可长期缓解,因此对部分H.pylori阳性FD患者根除H.pylori是一种值得推广的有效治疗手段。

Background： Functional dyspepsia （FD） is a highly prevalent disorder. The need of Helicobacter pylori （H. pylori） eradication in H. pylori-positive FD patients is still controversial. Aims： To assess the effect of H. pylori eradication on H. pylori-positive FD patients. Methods： A total of 200 H. pylori-positive FD patients were randomly divided into treatment group （100 patients received ranitidine bismuth citrate 400 mg ＋ amoxicillin 1000 mg ＋ clarithromycin 250mg, twice a day for 7 days） and control group （100 patients received hydrotaleite 1000 mg, thrice a day for 7 days）. H. pylori eradication rate and FD symptoms were monitored after follow-up. Results： H. pylori eradication rate in treatment group was 87.5% （PP analysis） and 84.0% （ITT analysis）, respectively, and was 0% in control group. The total efficacy rate of FD symptoms in H. pylori-eradicated patients was significantly higher than that in H. pylori-non- eradicated patients and control group （90.5% vs. 41.7% and 45.9%, P〈0.01）. Conclusions： Some FD patients with H. pylori infection may obtain long-term symptomatic relief by eradication of H. pylori, which supports that eradication of H. pylori is a clinical effective and worth popularizing treatment for some patients.