雷贝拉唑四联疗法治疗幽门螺杆菌阳性消化性溃疡的临床研究

CLINICAL STUDY ON THE EFFECTS OF RABEPRAZOLE IN QUADRUPLE THERAPY FOR THE TREATMENT OF HELICOBACTER PYLORI POSITIVE PEPTIC ULCER

目的观察雷贝拉唑四联疗法治疗幽门螺杆菌阳性消化性溃疡的临床疗效和安全性。方法将66例幽门螺杆菌阳性的消化性溃疡患者随机分为治疗组和对照组,各33例。治疗组:实行LBMT方案,即雷贝拉唑40mg(1次/d)、胶体次枸橼酸铋220mg(2次/d)、甲硝唑400mg(2次/d)、四环素750mg(2次/d),口服10d。对照组实行LAC方案:雷贝拉唑40mg(1次/d)、阿莫西林1.0g(2次/d)、克林霉素500mg(2次/d),口服7d。疗程结束1月后行14 C尿呼气试验测试。结果治疗组总有效率为91%,对照组为70%,治疗组高于对照组(χ2=4.69,P<0.05)。治疗组14C尿素呼气试验转阴率为97%,对照组转阴率为76%,两组HP转阴率比较有显著差异(χ2=4.63,P<0.05)。结论在传统三联疗法HP根除率低的情况下,雷贝拉唑、铋剂、甲硝唑和四环素的四联疗法可为首选方案。

Objective To observe the efficacy and safety of rabeprazole in quadruple therapy for the treatment of helicobacter pylori（HP） positive peptic ulcer.Methods 66 patients with HP positive peptic ulcerwere randomly divided into the treatment group and the control group（33cases in each group）.The quadruple therapy of oral administration of 40mg of rabeprazole once per day,220 mg of colloidal bismuth subcitrate twice per day,400 mg of arilin twice per day and 750 mg of tetracycline twice per day was used in the treatment group for ten days.Oral administration of 40 mg of rabeprazole once per day,1.0 g of amoxicillin twice per day and 500mg clindamycin twice per day was used in the control group for seven days.The 14C urea breathe test was conducted one month later after the course of treatment was completed.Results The total effective rates in the treatment group and the contrast group were 91% and 70% respectively（χ2=4.69,P〈0.05）.The 14C urea breathe test revealed that the HP negative transfer rates in the treatment group and the contrast group were 97% and 76% respectively（χ2=4.63,P〈0.05）.Conclusion Compared with the routine triple therapy,the quadruple therapy of using rabeprazole,bismuth,arilin and tetracycline can produce better effects in treating HP positive peptic ulcer.