洛赛克三联疗法对幽门螺杆菌根除及溃疡病发病影响的人群研究

Losec triple therapy for the eradication of H. pylori and the morbidity of peptic ulcer A mass screeningstudy

目的 研究胃癌高发地区自然人群中Ｈｐ 感染率以洛赛克为核心的三联疗法对幽门螺杆菌阳性患者的根治疗效及对溃疡病的发病情况的影响。方法 采用随机对照方法，在胃癌高发区自然人群中选择３５ ～７５ 岁１００６ 例行胃镜检查，将快速尿素酶及组织学ＷａｒｔｈｉｎＳｔａｒｒｙ 染色均阳性者定为Ｈｐ 感染，共发现Ｈｐ 阳性５５２ 例，感染率为５４．９％ 。将Ｈｐ 阳性者随机分为两组，治疗组用洛赛克２０ｍｇ、克拉霉素５００ｍｇ 及阿莫西林１０００ｍｇ，每日２ 次，口服；安慰剂做对照；疗程１ 周。结果 停药１ 个月后行１３Ｃ－ 尿素呼气试验，Ｈｐ 根除率为８８．８９ ％ （２２４／２５２ 例）。Ｈｐ 根除一年后再次胃镜检查，发现治疗组溃疡病９ 例（３ ．７０ ％） ，明显低于１ 年前２７ 例（９ ．８７ ％ ），差异有非常显著性（ Ｐ＜０ ．００５）；而对照组溃疡病３２ 例（１２ ．８５ ％ ），与治疗组相比差异有非常显著性（ Ｐ＜ ０．００５）。治疗组与对照组溃疡复发率分别为３ ．７０ ％（１／２７）和４２．８６％ （９／２１） ，差异有非常显著性（ Ｐ＜ ０ ．００５）。结论 以洛赛克为核心的三联１周疗法，具有疗程短、疗效高、副作用少等优点，是当前较为理想的根除Ｈ?

Objective Toinvestigatethe Hp eradication and therelation betweenthe Hpinfection and morbidity ofpeptic ulcerin the generalpopulation. Methods Onethousand and six adultsamong the 35 75 yearsold group were selected from generalpopulation in the high incidence region of gastric cancerinto this study.Among them ,552 individuals were confirmed to have Hp positive with CLOtest( + ) and Wathin Starry Stain(+ ) histological. Allthe Hp positiveindividuals were randomly divided into two groups,treat mentgroup with one week triple therapy: Losec 20 mg twice daily,clarythromycin 500mg twice daily and amoxicillin 100mg twice daily,placebo group was as control.One month aftercompktion oftreatment, Hp status wasreassessed by 13C UBT.One yearlater,allrandomized subjects were had repeated the endoscopy and biopsy.Results Hpinfectionratein adultpopulation was54 .9% .Eradication rate of Hp with OACone weektripletherapy was 88.89% .Beforetreatment,the presenceofpeptic ulcerinthetreatmentand placebo groups wasplacebo groups was9 .87 %(27/276)and7 .61 %(21/276),respectively,there wereno difference between thetwo groups.One yearlater,the peptic ulcerin thetwo groups was3 .7% (9/243) and 12.85% (32/249) respectively ( P< 0 .005).Therecurrencerate ofpeptic ulcer was 3.7% (1/27) and 42.86 % (9/ 21) respectively ( P<0 .005),the new occurrence rate of peptic ulcer was3 .29% (8/243) and 9 .24% (23/ 249) respectively (P< 0.005) ,there being a significant difference between the two groups.Conclusions One week OACtripletherapyis ofa shortcourse,well tolerated and effective treatmentfor Hp eradication , the eradication of whichisassociated with asignificantreductionin therateofpeptic ulcerrecurrence and o