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目的 探讨不同抗生素组合、不同剂量及不同疗程的三联疗法对幽门螺杆菌 (Hp)的根除效果。方法 2 4 8例经胃镜确诊的活动性十二指肠溃疡患者 ,经Hp检查阳性。患者随机分成6个组进行治疗 ,于治疗结束后 4周复查胃镜 ,观察溃疡愈合率和重复Hp检查观察Hp根除率。比较含克拉霉素和不含克拉霉素的奥美拉唑三联疗法对Hp的根除效果。质子泵抑制剂 (PPI)三联疗法1周与 2周的治疗效果。比较克拉霉素 2 5 0mg与克拉霉素 5 0 0mg不同剂量的治疗效果。随访溃疡愈合后 1年的溃疡复发率。结果 2 4 8例患者中 2 2 8例溃疡愈合 ,其中有 2 8例Hp未根除 ,2 0 0例Hp被根除。在 2 8例Hp未根除的溃疡愈合患者中 17例参加随访 ,半年溃疡复发 7例 ,复发率 4 1 2 % ,1年复发 10例 ,复发率 5 8 9% ;在Hp根除的 2 0 0例溃疡愈合患者中 ,130例参加随访 ,半年溃疡复发率为0 ,1年复发 3例 ,复发率 2 3%。含克拉霉素的PPI三联疗法 ,Hp的根除率明显高于不含克拉霉素的三联疗法 ;克拉霉素 2 5 0mg与 5 0 0mg 2个剂量的对比研究 ,Hp的根除率差异无显著意义 ;1周与 2周治疗Hp根除率和溃疡治愈率差异无显著意义 ;根除Hp可以明显降低溃疡复发率或治愈溃疡。 结论 含奥美拉唑和克拉霉素的短程 ( 1周 )和低剂量 (克拉霉素 2 5 0mg)的三联
Objective To investigate the eradication effect of Helicobacter pylori (Hp) by different combination of antibiotics, different doses and different courses of triple therapy. Methods Twenty-eight patients with active duodenal ulcer diagnosed by endoscopy were tested positive by Hp. Patients were randomly divided into six groups for treatment. Gastroscopy was performed 4 weeks after the end of treatment, and the healing rate of the ulcer and the Hp eradication rate were observed by repeated Hp examination. Efficacy of clarithromycin and clarithromycin-free omeprazole triple therapy on Hp eradication was compared. Proton pump inhibitor (PPI) triple therapy for 1 week and 2 weeks of treatment. Compare clarithromycin 250mg and clarithromycin 500mg different doses of the therapeutic effect. Follow-up ulcer recurrence rate 1 year after ulcer healing. RESULTS: Twenty-eight of the 28 patients had healed ulcers, of which 28 were not eradicated and 220 were eliminated. Seventeen patients with ulcer healed without Hp eradication participated in the follow-up. Seven patients had a half-year ulcer recurrence, the recurrence rate was 42.1%, one year recurrence was 10 and the recurrence rate was 58.9% Cases of ulcer healing patients, 130 patients participated in the follow-up, six-year ulcer recurrence rate was 0, 1 year recurrence in 3 cases, the recurrence rate of 23%. Clarithromycin triple therapy with PPI, Hp eradication rate was significantly higher than those without clarithromycin triple therapy; clarithromycin 250mg and 500mg 2 doses of the two studies, the Hp eradication rate was no significant difference ; 1 week and 2 weeks treatment of Hp eradication rate and ulcer cure rate was no significant difference; eradication of Hp can significantly reduce the recurrence rate of ulcers or cure ulcers. Conclusion Triad of short-course (1 week) and low-dose (clarithromycin 250 mg) doses of omeprazole and clarithromycin