灭Hp胶囊三、四联疗法对Hp相关消化性溃疡疗效及胃粘膜保护作用的双盲对照研究

Gastroprotective effect and clinical efficacy of killing Hp Triple or Quadruple therapy on peptic ulcer patients : A prospective,randomized,double- blind,placebo controlled study

目的 观察中西医结合疗法对消化性溃疡 (PU)的疗效及胃粘膜保护作用。方法 采用前瞻性、随机双盲、安慰剂对照研究 ,93例Hp阳性PU被随机分为 4组。A组 (新三联 ) :兰索拉唑 (达克普隆 ) +阿莫西林 +克拉霉素 ;B组 (灭Hp胶囊四联 ) :新三联 +灭Hp胶囊 ;C组 (灭Hp胶囊三联 ) :兰索拉唑 +克拉霉素+灭Hp胶囊 ;D组 (安慰剂 ) :胃舒平。双盲双模拟用药。治疗前及治疗后 4周复查胃镜 ,并检测胃粘膜磷脂、氨基己糖和血清表皮生长因子 (EGF)。结果 Hp根治率B、C组与A组分别为 96 4%、 92 0 %和 92 0 % ;溃疡愈合率分别为 10 0 0 %、 92 0 %和 88 0 % ,三组间差异无显著性 ,明显高于D组 (分别 0 0 % ,2 0 0 % ) (均P <0 0 5 )。B、C组胃粘膜磷脂、氨基己糖和血清EGF含量治疗后明显高于治疗前 (均P <0 0 5 )。A组仅氨基已糖较治疗前升高 ,D组磷脂、氨基己糖和EGF治疗后较治疗前无明显变化 (P >0 0 5 )。结论 灭Hp胶囊三、四联疗法具有高效的Hp根除、溃疡愈合及胃粘膜保护作用。

Objective To investigate the effects of the killing Hp triple and quadruple therapy on healing of ulcer and its protective effect on gastric mucosa of peptic ulcer.Methods This was a prospective, randomized, double-blind,placebo controlled study. 93 patients with positive Hp active peptic ulcer were randomly divided into four groups, under double-blind and double-mimic condition, to receive one of the following four regimens: new triple therapy(group A):lansoprazole plus clarithromycin plus amoxycillin; killing Hp quadruple therapy(group B): three abovementioned drugs plus recipe of killing Hp ; Killing Hp triple therapy(group C): Lansoprazole plus clarithromycin and recipe of killing Hp ; Placebo (group D): gastropine.The ulcer healing states were evaluated for 4 weeks after treatment ; antral mucosal phospholipid and hexosamine and serum epidermal growth factor(EGF)were measured before and 4 weeks after completing treatment Results Both the healing rate in group B and C(100% and 92% vs 20% in D,respectively,P<0 005)and the Hp eradication rate in groups B and C ( 96 4% and 92%vs 0 0% in D,respectively,P<0 005) were significantly higher than those in group D, and slightly higher than those in group A (92% and 88%, respectively,P> 0 05) Comparing with before treatment, the content of gastric mucosal phospholipid, hexosamine and serum EGF after treatment were significantly increased in group B and in group C ; only the hexosamine was significantly increased in group A; the above indexes were not obviously increased in group D Conclusion The killing Hp triple and quadruple therapy has higher efficacy for ulcer healing and eradication of Hp,and has cytoprotective effect