幽门螺旋菌阳性消化性溃疡治疗的前瞻性研究

A Prospective Trial of Treatment of Helicobacter Pylori Positive peptic Ulceration

本文将确诊为幽门螺旋菌(HP)阳性的消化性溃疡72例随机分为三组,分别口服国产雷尼替丁、得乐、羟氨苄青霉素(RDA 组);得乐、羟氨苄青霉素(DA 组)治疗,并与单服雷尼替丁(R 组)对照,四周后经胃镜复查。溃疡愈合率三组分别为83.3%、76%及76.5%。RDA 组疗效优于其它二组(P<0.01),而 DA 组与 R 组间无显著性差异(P>0.05),HP 阴转率分别为86.7%、84%及11.8%,RDA 与 DA 治疗组显著高于单用抗酸(R)组(P<0.01),而 RDA 组与DA 组间无显著性差异(P>0.05)。HP 阴转的溃疡愈合率是87.8%(43/49),未阴转的愈合率是60.9%(14/23)(P<0.01),提示抗 HP 药加抗酸药联合疗效最佳;溃疡愈合与 HP 阴转有较好的相关性(P<0.025);说明 HP 的存在可能是影响溃疡愈合的因素之一。

This paper randomizes 72 patients with Helicobacter pylori(HP)positi- ve peptic ulcer into two separate treatment groups and a compared group. The patients in the three groups took homemade Ranitidine,De-Nol,Amo- xicillin(RDA);De-Nol,Amoxicillin(DA);and Ranitidine(R)respecti- vely.All cases were recheckee with gastroscopy after four weeks.The heal- ing rates of the ulcer in the three groups were 83.3%,76.0% and 76.5%.These Therapeutic effect showed that RDA group was better than other groups(P <0.01);DA group and R group were not very different(P>0.05).The changed negative rates of HP in the three groups were 86.7%,84.0% and 11.8%.Two treatment groups were better than R(anti-acidic drug)group (P<0.01),and RDA group and DA group were not very different(P> 0.05).The healing rates of HP changed negative ulcers were 87.8%(43/49), the healing rates of non-changed were 60.9%(14/23),(P<0.01).It show- ed the therapeutic effect was the best if anti-HP drug and anti-acid drug were combined.There was a better positive correlation between the healing of the ulcer and the negative changing of HP.This suggested the infection of HP may be a factor influencing the healing of the ulcer.