奥美拉唑短程三联疗法对根除幽门螺杆菌及溃疡愈合的探讨

A Study on the Effect of 1 week Triple Therapies with Omeprazole in Eradication of Helicobacter Pylori and Healing of Duodenal Ulcer

目的 :探讨含奥美拉唑的短程三联疗法对Hp阳性的十二指肠溃疡的疗效 ,以及对十二指肠溃疡复发的影响。方法 :12 8例Hp阳性的十二指肠溃疡病人随机分成三组 ,A组口服奥美拉唑 (洛赛克 ) 2 0mg每日 2次 ,克拉霉素 2 5 0mg每日 2次 ,甲硝唑 40 0mg每日 2次 ,疗程为 1周 ;B组用药同A组 ,疗程为两周 ,C组在A组的用药基础上加用铋剂 (德诺 )2 40mg每日两次 ,疗程为 1周。于停药后 1月以及 12月后复查胃镜。结果 :A组患者Hp根除率为 91.11% ,B组 95 .12 % ,C组为 92 .86 % ,A组与B组、A组与C组比较 ,经统计学处理 ,P值均 >0 .0 5 ,故差异无显著性 ;三组患者溃疡愈合率分别为75 .5 6 %、82 .93 %和 80 .95 % ,经统计学处理 ,P >0 .0 5 ,故差异亦无显著性。三组患者 1年后溃疡复发率分别为 5 .88%、2 .94%及 2 .86 % ,P >0 .0 5 ,无显著性差异。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Hp治疗方案。Hp根除可有效地防止溃疡病的发生与复发。

Objective:To investigate the effect of 1 week triple therapies with omeprazole in eradication of Helicobacter pylori(Hp) infection in duodenal ulcer and recurrence of ulcer.Methods:128 patients with Hp positive duodenal ulcer proven by gastroscopy were divided into 3 groups at random,group A were treated with omeprazole(Losec)20mg plus clarithromycin 250mg plus metronidazole 400mg,orally,twice a day for a week;Group B took the same drugs as Group A,for 2 weeks;Group C added tri potassium dicitratobis muthate(De Nol)besides the drugs taken in Group A for a week.All patients had been checked by endoscopy a month and 12 months after the end of the treatment.Results:The eradication rate of Hp of Group A was 91.11%,Group B was 95.12% and Group C was 92.86%;the ulcer healing rates of 3 groups were 75.56%,82.93% and 80.95%,respectively.There was no statistically significant difference in eradication rates and ulcer healing rates between Group A and B or Group A and C ( P >0.05);the recurrence rates of ulcer were 5.88%,2.94% and 2.86% after a year,respectively.There was no significant difference as well( P >0.05).Conclusion:1 week triple therapy with omeprazole is an effective regime to Hp eradication and can prevent recurrence of duodenal ulcer effectively.