两种方案治疗十二指肠溃疡幽门螺杆菌感染的临床分析被引量：9

Clinical analysis on two therapies eradicating Helicobacter pylori infection in patients with duodenal ulcer

导出

摘要目的　分析小剂量奥美拉唑、左氧氟沙星及呋喃唑酮新三联与小剂量奥美拉唑、阿莫西林及甲硝唑标准三联疗法治疗十二指肠溃疡幽门螺杆菌 (Helicobacterpylori,Hp)感染的临床疗效对比。方法　 98例符合条件的患者随机分成两组 ,其中 4 7例为新三联疗法 ,即口服小剂量奥美拉唑 2 0mg,1次 /d ,连服 6周 ,左氧氟沙星 2 0 0mg及呋喃唑酮 2 0 0mg ,均为 2次 /d ,连服 2周。另一组 5 1例为标准三联疗法 ,即口服小剂量奥美拉唑 2 0mg ,1次 /d ,连服 6周 ,阿莫西林 10 0 0mg及甲硝唑 4 0 0mg ,均为 2次 /d ,连服 2周 ,疗程结束后 1个月复查胃镜。结果　 96例患者完成治疗及随访 ,小剂量奥美拉唑新三联组与小剂量奥美拉唑标准三联组疗法Hp根除率分别为84 .8%、82 .0 % ,差异无统计学意义 (P =0 .715 ) ;溃疡愈合率分别为 95 .7%、92 .0 % ,差异无统计学意义 (P =0 .75 2 )。两组患者不良反应发生率分别为 12 .8%、15 .7% ,差异无统计学意义 (P =0 .6 80 )。Hp根除组溃疡愈合率 (10 0 .0 % )明显高于Hp未根除组(6 2 .5 % ) ,差异有统计学意义 (P =0 .0 0 1)。结论　小剂量奥美拉唑新三联组与标准三联组疗法均有较理想的Hp根除率及溃疡愈合率 ,新三联组疗法不良反应发生率与标准三联组疗法相当 ; Objective To investigate the effects of the two met hods to treat Helicobacter pylori(Hp)infection in patients with duodenal ulcer(DU):a new triple therapy with 6-week low-dose omeprazole(Ome) and 2-week of levofloxacin plus furazolidone (OVF)compared with a standard triple therapy with 6-week low-dose Ome and 2-week of amoxicillin plus metronidazole(OAM) for ulcer healing , Hp eradication in DU and side effects of drugs. Methods Ninety-eight DU patients,confirmed by endoscopy with Hp infection(confirmed by 14C-UBT and pathology),were divided randomly into two groups,OVF group and OAM (triple therapy )group. Results Ninety-six patients received one of the therapies and were followed up. The ulcer healing rates were 95.7% and 92.0% respectively in OV and OAM groups(P= 0.752).The eradication rates of Hp were 84.8% and 82.0%(P= 0.715) respectively. There were no difference in the side effects of OV group( 12.8%) and OAM group( 15.7%)(P= 0.680). The ulcer healing rates were 100.0% and 62.5% respectively for Hp eradication and failure of Hp eradication group (P= 0.001). Conclusion Considering the effectiveness, the OVF therapy has efficacy as the OAM therapy, especially the rates of ulcer healing are higher in patients with Hp infection eradication. Nowadays the rate of routine antibiotics (metronidazole and amoxicillin) resistance is rising, the new triple therapy will be the first treatment selected for Hp-infected patients after failure of standard triple therapies.

作者徐光辉凌国敏

机构地区上海市闸北区中心医院消化科上海市闸北区中心医院内镜室

出处《临床荟萃》 CAS 北大核心 2005年第1期19-21,共3页 Clinical Focus

关键词十二指肠溃疡幽门螺杆菌感染治疗 duodenal ulcer helicobacter pylori infection therapy

分类号 R573.6 [医药卫生—消化系统]

引文网络
相关文献

参考文献4

1UEMEURA N, OKAMOTO S, MUKAI T, et al. Effect of Helicobacter pylori eradication on the healing and recurrence of pepcic ulcer: combination therapy with low-dose omeprazole and clarithroimycin[J]. Eur J Gastroenterol Hepatol, 1995,7 ( Suppl1) :67-89.
2AVERY G, DANGERUTA K, GARY S, et al. Metronidazole resistance in Helicobacter pylori is due to null mutations in agene (rdxA) that encodes an oxygen-insensitive NADPH nitroreductase[J]. Mol Microbiol,1998,28 (2) :383 393.
3CHIBA N, MARSHALL C P. Omeprazole once or twice daily with clarithroimycin and metronidazole for helicobacter pylori[J]. Can J Gastroenterol, 2000, 14 (1) : 27-31.
4CAMMAROTA G, CIANCI R, CANNIZZARO O. High-dose versus low-dose clarithromycin in 1-week triple therapy,including rabeprazole and levofloxacin, for Helicobacter pylori eradication[J]. J Clin Gastroenterology, 2004,38 (2) : 110-114.