幽门螺杆菌阳性十二指肠溃疡根除治疗后远期疗效观察

Observation of Long-time Effectiveness for Eradicating Helicobacter Pylori in Duodenal Ulcer Disease

目的 :为了研究幽门螺杆菌 (Hp)阳性十二指肠溃疡根除治疗后远期疗效。方法 :将 10 2例Hp阳性的十二指肠溃疡病人随机分成 3组 ,A组采用奥美拉唑、得诺两联治疗 ,B组采用奥美拉唑、阿莫西林、甲硝唑三联治疗 ,C组采用奥美拉唑、克拉霉素、阿莫西林三联治疗 ,均为 1周 ,以后统一用奥美拉唑治疗 3周。结果 :A ,B ,C三组溃疡愈合率分别为 :83 .3 %、90 .6%、94.1%。Hp根除率分别为 5 0 %、90 .6%、91.1%。 3年以后Hp根除后的再感染率分别为 :44 .4%、6.9%、6.2 % ,溃疡复发率为 5 5 .5 %、6.9%、0 %。A组与B组、C组之间有显著差别。结论 :B组和C组三联 1周疗法用于治疗Hp阳性十二指肠溃疡具有短程、Hp根除率高、阳转率低、成本 /效益佳等优点。

Objective:To study the long time effectiveness for eradicating Hp in duodenal ulcer.Methods:102 patients with Hp infection and duodenal ulcer were randomly divided into 3 groups.Group A was treated with double therapy (Omeprazole plus Denole) for one week; Group B with triple therapy (Omeprazole plus Amoxicillin and Metronidazole) for one week; Group C with triple therapy (Omeprazole plus Amoxicillin and Clarthromycin) for one week. All of them were treated with Omeprazole continuonsly for three weeks. Results:The ulcer healing rate was 83.3% in group A,90.6% in group B,and 94.1% in group C.The eradication rate of Hp was 50% in group A,90.6% in group B,and 91.1% in group C. At the end of three years, the positive eradication rate of Hp was 44.4% in group A, 6.9% in group B,and 6.2% in group C. The ulcer relapse rate was 55.5% in group A, 6.9% in group B,and 0% in group C. There was a significant difference between group A and group B as well as group A and group C. Conclusion:The one week OAC and OAM triple therapies of eradicating Hp are both effective short course and cost effective treatment of duodenal ulcer diseases.