雷贝拉唑四联疗法治疗良性胃溃疡43例

Clinical Efficacy of Rabeprazole Quadruple Therapy on Innocent Gastrelcosis in 86 Cases

目的观察雷贝拉唑四联疗法治疗幽门螺旋杆菌(HP)阳性良性胃溃疡的临床疗效。方法选择86例HP阳性良性胃溃疡患者,将其随机分为治疗组和对照组,各43例。治疗组口服雷贝拉唑10 mg,枸橼酸铋雷尼替丁350 mg,阿莫西林1 000 mg,呋喃唑酮100 mg,均2次/天,共4 d。对照组口服奥美拉唑20 mg,阿莫西林1 000 mg,克拉霉素500 mg,均2次/天,共7 d。抗HP治疗后继续服用雷贝拉唑10 mg或奥美拉唑20 mg,1次/天,疗程4周。观察治疗后4周时的HP根除率、溃疡愈合率及随访半年、1年时的HP再感染率和溃疡复发率。结果治疗4周后,治疗组和对照组HP根除率分别为95.35%和76.74%,差异有统计学意义(P<0.05);溃疡愈合率分别为93.02%和88.37%,差异无统计学意义(P>0.05)。治疗组和对照组随访半年HP再感染率分别为7.50%和23.68%,溃疡复发率分别为5.00%和21.05%,差异均有统计学意义(P<0.05);随访1年HP再感染率分别为12.50%和42.11%,溃疡复发率分别为10.00%和36.84%,差异均有统计学意义(P<0.05)。结论雷贝拉唑和枸橼酸铋雷尼替丁组成的四联疗法是一种短程、高效、安全的根除HP和促进溃疡愈合的方法。

Objective To observe the efficacy of the rabeprazole quadnlple therapy on HP-positive innocent gastrelcosis. Methods Eighty- six patients with HP- positive innocent gastrelcosis were randomly divided into the treatment group and the control group, 43 cases in each group. The treatment group received oral rabeprazole 10 mg, ranitidine bismuth citrate （RBC） 350 mg, amoxicillin 1 000 mg and furazolidone 100 mg, twice daily for 4 days. The control group received oral omeprazole 20 rag, amoxicillin I 000 mg and clar- ithromycin 500 rag, twice daily for 7 days. After anti- HP treatment, rabeprazole 10 mg or omeprazo 120 mg was continuously used, once daily for the treatment course of 4 weeks. The HP eradication rate and the ulcer healing rate after 4- week treatment, and the HP reinfection rate and the ulcer relapse rate during 6- month or 1- year follow up were observed. Results After 4- week treatment, the HP eradication rates of the treatment group and the control group were 95.35% and 76.74% respectively, the difference had statistical significance（ P 〈0.05）; the ulcer healing rates were 93.02% and 88.37% respectively, the difference had no statistical significance （P 〉 0.05）. During 6- month follow- up, the HP reinfection rates were 7.50% and 23.68% respectively, the ulcer relapse rates were 5.00% and 21.05% respectively, the differences had statistical significance（ P 〈 0.05）. During 1 -year follow -up, the HP reinfection rates were 12.50% and 42. 11% respectively, the ulcer relapse rates were 10.00% and 36.84% respectively, the differences had sta- tistical significance（ P 〈 0. 05）. Conclusion The quadruple therapy of rabeprazole and RBC is a short- course, highly effective and sMe method for eradicating HP and promoting ulcer healing,