铋制剂、洛赛克、替硝唑治疗幽门螺杆菌阳性消化性溃疡的近期和远期疗效观察

Long-term and Short-term Effect of Bismuth,Losec and Tinidazole Combination Therapy on the Patients with Heliocobacter pylori-associated Peptic Ulcer

目的 :观察铋制剂、洛赛克、替硝唑治疗幽门螺杆菌 (Hp)阳性消化性溃疡的近期和远期疗效。方法 :将10 2例患者随机分为两组 ,治疗组 (5 2例 ) :丽珠得乐冲剂 1.0 g,1d4次 ;洛赛克 2 0 mg,替硝唑 0 .5 g,1d2次口服 ;疗程 2周。对照组 (5 0例 ) :洛赛克 2 0 mg,qd头孢羟氨苄 0 .5 g,1d4次 ;甲硝唑 40 0 mg,1d2次 ;疗程 2周。疗程结束后 2周行胃镜检查 ,病理检查及 Hp检测 ;并于半年 ,1年进行相应的随访 ,结果 :治疗组和对照组溃疡愈合率分别为 90 .38%和 88.0 0 % ,Hp根除率分别为 88.46 %和 86 .0 0 % ,两组比较无显著差异 (P >0 .0 5 )。治疗组疗程后半年、1年溃疡复发率为 2 .17%和 4.35 % ,Hp再发率为 4.35 %和 6 .5 2 % ;对照组疗程后半年、1年溃疡复发率为14.2 9%和 19.0 5 % ,Hp再发率为 19.0 5 %和 2 1.43%。两组比较有显著差异 (P <0 .0 5 )。铋制剂、洛赛克加替硝唑治疗 Hp阳性溃疡的远期疗效优于洛赛克加两种抗生素的疗效 ,差异显著 (P <0 .0 5 )。结论 :两种疗法近期疗效相似 ,但远期疗效治疗组优于对照组 (P >0 .0 5 )

Objective:To study the long term and short term effect of bismuth combined with losec,tinidazole on the patients with positive helicobacter pyolri(H.pylori)peptic ulcer.Methods:102 patients with positive H.pylori peptic ulcer were diagnosed by endoscopic examination and were randomized into two groups:treatment group(52 cases) received De Nol (1.0 g,qid),losec(20 mg,qd),tinidazole(0.5 g,bid)and control group(50 cases)losec(20 mg,qd)combined with amoxicillin(0.5,qid),metronidazole(400 mg,bid)for 2 weeks.Clinical,endoscopic,pathological and bacterioogical evaluations were made 1/2 months,6 months and 12 months respectively after the treatment.Results:Ulcer healing rates were 90.38% and 88.00% in treatment group and control group,respectively(P> 0.05 );eradication rates of H.pylori were 88.46% and 86.00% in treatment and control group,respectively(P> 0.05 );6 months,12 months after the treatment,recurrence rates of peptic ulcer in treatment gronp were significantly lower than those of control group,respectively(2.17% vs 14.29% and 4.35% vs 19.05%),and H.pylori reinfection rates in treatment group were also significantly lower than those of control group,respectively(4.35%vs 19.05% and 6.52% vs 21.43%)and P< 0.05 .Conclusions:The long term effect of bismuth,losec and tinidazole combination therapy(2 weeks)is better than that of losec combined with amoxicillin and metronidazole for H.pylori associated peptic ulcer.