雷贝拉唑三联疗法根除幽门螺杆菌感染

Rabeprazole-based triple therapy for the eradication of helicobacter pylori infection

目的 观察雷贝拉唑三联短程疗法根除幽门螺杆菌及治疗十二指肠溃疡的疗效。方法 12 0例经胃镜检查确诊为十二指肠溃疡并经快速尿素酶实验和病理学检查确定为Hp阳性的病人随机分为两组 :雷贝拉唑组和奥美拉唑组。两组先予以三联疗法 :雷贝拉唑 10mg或奥美拉唑 2 0mg、阿莫西林 1g及克拉霉素 5 0 0mg ,每日 2次 ,连续 7d ,然后予雷贝拉唑 10mg或奥美拉唑 2 0mg ,每天 1次 ,连续 7d ,疗程结束后 4周复查胃镜并检测Hp ,并记录用药后病人症状的改变程度。结果 113例完成治疗方案。其中雷贝拉唑组Hp根除率为 93 0 % ,奥美拉唑组为 85 7% ,两组间差异无显著意义 (P >0 0 5 ) ;雷贝拉唑组 2周溃疡愈合率为 94 7% ,奥美拉唑组为 78 6 % ,雷贝拉唑组明显高于奥美拉唑组 ,两组差异有显著意义 (P <0 0 5 ) ;雷贝拉唑组第 1、3d症状缓解率分别为 70 1%、91 2 % ,奥美拉唑组为 39 3%、6 7 8% ,两组比较差异有显著意义 (P<0 0 5 )。结论 雷贝拉唑、克拉霉素和阿莫西林三联短程疗法能有效根除Hp及高溃疡愈合率 ,并能迅速缓解症状 ,与奥美拉唑三联疗法相比较 ,在Hp根除率上差异无显著意义 ,在 2周溃疡愈合率及症状缓解率方面 ,雷贝拉唑要明显优于奥美拉唑。

Objective The clinical outcome of rabeprazole based triple therapy for the eradication of helicobacter pylori(Hp) infection and the efficaacy on healing of duodenal ulcer was reviewed.Methods 120 patients with Hp infection proven by both histology and rapid urease test and active duodenal ulcer by endoscopy were divided at random into rabeprazole group and omeprazole group.The two groups were firstly treated with triple therapy:clarithromycin 500mg bid and amoxicillin 1g bid together with either rabeprazole 10mg bid(rabeprazole group) or omeprazole 20mg bid(omeprazole group) for 7 days and then either rabeprazole 10mg qd or omeprazole 20mg qd for another 7 days.The eradication rates of Hp and the healing rates of duodenal ulcer were evaluated by endscopy on the 28th day after completion of treatment and recording degree of the relieves of the symptoms.Results 117 patients completed the study.The eradication rate of Hp in rabeprazole group and omeprazole group were 93.0% and 85.7%,there was no statistically significant difference between the two groups(P>0.05).The two weeks ulcer healing rates in rabeprazole group and omeprazole group were 94.7% and 78.6%.The difference between the two groups was statistically significant(P<0.05).The symptoms remissioning rate on the 1st and 3rd day in rabeprazole group and omeprazole group were 70.1%,91.2% and 39.3%,67.8%,there was statistically significant difference between the two groups(P>0.05).Conclusion Rabeprazole based triple therapy can eradicate Hp and increase high ulcer healing and remission of the symptoms of patients effectively.The eradication rate of Hp is not different between the two groups,the two weeks ulcer healing rate and the symptoms remissioning rate in rabeprazole group is higher than that in omeprazole group.