四联疗法与三联疗法根除幽门螺杆菌感染的对比研究

A controlled trial comparing omeprazole bismuth and clarithromycin quadruple therapy versus bismuth triple therapy in anti-H.pylori treatment and curing duodenal ulcer

目的 :对比研究含胶体次枸橼酸铋(CBS)四联疗法与CBS三联疗法治疗幽门螺杆菌 (H.pylori)的根除率、十二指肠溃疡 (DU)的愈合率及安全性。方法 :将72例经胃镜等方法确诊H.pylori阳性的DU患者随机分为两组。A组36例 ,给予Ome20mg +Amox500mg +CLari250mg,均bid和CBS120mg,qid用药 ,疗程7天 ;后继服Ome20mg,qd给药 ,21天。B组36例 ,给予CBS120mgqid +Amox500mgbid +CLari250mgbid用药 ,疗程14天 ;后继服CBS240mg,bid给药,14天。结果 :A组H.pylori根除率为97.2 % ,DU愈合率为97.2% ,副反应发生率为5.6 % ;B组相应为80.5% ,86.1 % ,36.1%。两组H.pylori根除率、DU愈合率差异无显著性 (P均>0.05) ,副反应发生率差异有显著性 (P<0.05) ,A组依从性好。结论 :Ome联用CBS、Amox、CLari治疗7天 ,根除H.pylori感染疗程短、疗效高、副反应少、依从性好 ,是较理想的H.pylori根除方案。

Objective:To compare the efficacy,side effect,safety and compliance of1-wk quadruple therapy and2-wk triple therapy in eradicating H.pylori and curing duodenal ulcer(DU).Methods:Seventy-two patients with DU and H.pylori infection by endoscopically and other methods,were randomly divided into two groups.Group A(n=36)were treated with1-wk quadruple therapy of Ome20mg bid+CLari250mg bid+Amox500mg bid+Colloidal bismuth subcitrate(CBS)120mg qid,then went on treating with Ome20mg,qd,for3-wk.Group B(n=36)were received with triple therapy of CBS120mg qid+CLari250mg bid+Amox500mg bid,for2-wk,then went on treating with CBS240mg,bid,for2-wk.Results:Group A(quadruple therapy)achieved97.2%of H.pylori eradication rate,97.2%of ulcer healing rate and5.6%of side effect rate,and those were80.5%,86.1%,36.1%respectively in group B(triple therapy).The H.pylori eradication rate,ulcer healing rate between A and B showed no significant difference(P>0.05),both their side effect rate had significant difference(P<0.05).Conclusion:For eradicating H.pylori infection,the1-wk quadruple therapy is short-term,highly effective,safer and well-compliance in ulcer healing.