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目的观察三联疗法治疗幽门螺杆菌(Hp)阳性十二指肠溃疡的临床疗效及不良反应。方法选择我院近年来诊治的Hp阳性活动性十二指肠溃疡患者68例,按随机原则分为治疗组和对照组各34例,治疗组采用(埃索美拉唑20 mg、阿莫西林1 000 mg、克拉霉素250 mg)三联疗法治疗,疗程7d;对照组仅给予埃索美拉唑治疗,疗程7 d,疗程结束28 d后观察两组临床疗效及Hp转阴率。结果两组治疗后临床症状均有不同程度好转,治疗组总有效率94.1%(32/34),对照组总有效率70.6%(24/34),两组比较差异有统计学意义,P<0.05;治疗组Hp转阴率88.2%(30/34),对照组转阴率35.3%(12/34),两组比较差异有统计学意义,P<0.01。治疗期间治疗组出现食欲差、恶心、腹胀3例,对照组出现1例,均能耐受继续服药,疗程结束停药后症状自行消失。结论埃索美拉唑、阿莫西林和克拉霉素三联疗法治疗幽门螺杆菌阳性十二指肠溃疡显示出良好的协同作用,具有疗程短、疗效好、临床愈合率和Hp根除率高、不良反应少、患者耐受性好等优点,值得临床推广应用。
Objective To observe the clinical efficacy and adverse reactions of triple therapy in the treatment of Helicobacter pylori (Hp) -positive duodenal ulcer. Methods Sixty-eight patients with active Hp-positive duodenal ulcer diagnosed and treated in our hospital in recent years were randomly divided into treatment group (34 cases) and control group (34 cases). The treatment group was treated with esomeprazole 20 mg, amoxicillin 1 000 mg, clarithromycin 250 mg) triple therapy for 7 days. The control group was given only esomeprazole for 7 days. After 28 days of treatment, the clinical efficacy and Hp conversion rate were observed. Results The clinical symptoms of both groups improved to some extent after treatment. The total effective rate was 94.1% (32/34) in the treatment group and 70.6% (24/34) in the control group, with significant difference between the two groups (P < 0.05). The negative rate of Hp in the treatment group was 88.2% (30/34), while the negative rate in the control group was 35.3% (12/34). There was significant difference between the two groups (P <0.01). During treatment, the treatment group showed poor appetite, nausea and abdominal distension in 3 cases, while in the control group, 1 case was able to tolerate. The symptoms disappeared on the end of treatment after stopping treatment. Conclusion Triple therapy of esomeprazole, amoxicillin and clarithromycin in treating Helicobacter pylori-positive duodenal ulcer shows good synergistic effect with short course of treatment, good curative effect, high clinical cure rate and high Hp eradication rate Less response, good patient tolerance and other advantages, it is worthy of clinical promotion and application.