四联疗法治疗消化性溃疡79例分析

Analysis of quadruple regimens for the treatment of 79 patients with peptic ulcer disease

目的探讨四联疗法对消化性溃疡的治疗作用及根除幽门螺杆菌的效果。方法将102例胃镜证实为消化性溃疡者随机分为三组,A组48例给予养胃舒1.2 g+雷尼替丁150 mg+阿莫西林500 mg+甲硝唑400 mg,Bid;对照组(C组,23例)给予雷尼替丁150 mg+阿莫西林500 mg+甲硝唑400 mg,Bid;B组31例给予铋剂220 mg+雷尼替丁150 mg+阿莫西林500 mg+甲硝唑400 mg,Bid;以上药物除抗菌药物只服用2周外,其余药物服至6周末疗程结束。第7周复查胃镜或^(13)C呼气试验。结果溃疡总愈合率A组、B组、C组分别为90.9%、100%、86.4%,S_2获得率分别为68.2%、73.1%和45.5%,Hp根除率分别为73.3%、76.1%和52.6%,症状缓解率大致相似,三组均无明显不良反应发生。结论雷尼替丁三联疗法加用铋剂和养胃舒均可使S_2获得率增加,同时Hp根除率上升,临床观察无明显不良反应。

Objective To study the efficacy of quadruple regimens for the treatment of peptic ulcer disease and eradication of Helicobacter pylori (Hp). Methods 102 patients with Hp associated peptic ulcer were randomly divided into three groups: group A (n=98) received sanjiuweitai-based quadruple regimen(Yang-weishul.2g,2/d+ranitidine150 mg,2/d+amoxicillin500 mg,2/d+metronidazole 400 mg,2/d); group B (n=31) received colloidal bismuth subeitrate(Livzon)110 mg,2/d+ranitidine150 mg, bid+amoxicillin500 mg,bid+metronidazole 400 mg,bid;group C (n=23) received ranitidine 150 mg,2/d+amoxicillin 500 mg, 2/d+metronidazole 400 mg. Antibioticshad been given for two weeks, the other drugs had been given for six weeks, the efficacies were determined by gastroscope or 13C-UBT. Results The ulcer healing rate was 90.9%,100%,86.4% in group A,B and C respectively; the stage S2 achivement rate was 68.2%.73.1% and 45.5%;the eradication rate of of Hp was 76.1%,73.3%and 52.6%,the symptoms were remissive similarly and no side effects in three groups. Conclusion Ranitidine-based triple regimen plus Livzon or Yangweishu can raise the stage S2 achievement rate and Hp eradication rate and no side effect be detected.