论文部分内容阅读
目的:通过与短程三联疗法比较,观察香连片联合三联疗法根除十二指肠溃疡患者幽门螺杆菌(Hp)感染的根除率和治疗十二指肠溃疡的疗效。方法:120例经胃镜检查确诊为十二指肠溃疡活动期并经快速尿素酶试验和血清抗Hp抗体(ELASE)或病理学检查确定为Hp阳性的患者分为4组:OACX组(奥美拉唑20mg+阿莫西林1000mg+克拉霉素250mg+香连片5片)、OMCX组(奥美拉唑20mg+甲硝唑400mg+克拉霉素250mg+香连片5片)、OAC组(奥美拉唑20mg+阿莫西林1000mg+克拉霉素250mg)和OMC组(奥美拉唑20mg+甲硝唑400mg+克拉霉素250mg),每日2次,连续7天。然后单独奥美拉唑20 mg,每日1次,连续28天,并于用药结束后第28～56天内作13C-尿素呼气试验判断Hp根除率的效果。同时在用药后第1、2、3、7、21和35天对患者的上腹痛、反酸以及上腹烧灼感等症状进行评估。结果:108例患者完成全部治疗方案,12例失访。Hp根除率检查结果显示OACX组的Hp根除率为92.9%(26/28),OMCX组为85.7%(24/28),OAC组为66.7%(18/27)和OMC组为60.0%(15/25)4组间差异有显著性(P<0.01)。症状改善情况:4组从用药第1天起均能有效改善患者的上腹痛、反酸、上腹烧灼感等症状,但是, OACX组和OMCX组的总得分下降幅度均显著高于OAC和OMC组(P<0.05～0.01)。结论:OACX组和OMCX组对Hp具有相当高的根除率,OACX组和OMCX组方案是适合我国国情的根除Hp行之有效的方案,而且,缓解十二指肠溃疡患者的症状, OACX组和OMCX组亦为优
Objective: To compare the eradication rates of Helicobacter pylori (Hp) infection in patients with duodenal ulcer and the therapeutic effect of duodenal ulcer by comparing with short-range triple therapy. Methods: One hundred and twenty patients diagnosed as active duodenal ulcer by gastroscopy and divided into 4 groups according to rapid urease test and serum anti-Hp antibody (ELASE) or pathological examination were divided into 4 groups: OACX group (Omeprazole 20mg + metronidazole 400mg + clarithromycin 250mg + contiguous tablets 5), OAC group (omeprazole 20mg + A) Moxillin 1000 mg + clarithromycin 250 mg) and OMC group (omeprazole 20 mg + metronidazole 400 mg + clarithromycin 250 mg) twice daily for 7 days. Then omeprazole alone 20 mg once daily for 28 days, and in the 28 to 56 days after the end of the medication for 13 C-urea breath test to determine the effect of Hp eradication rate. At the same time on the 1st, 2nd, 3rd, 7th, 21st and 35th days after treatment, the patients were evaluated on the symptoms of upper abdominal pain, acid reflux and upper abdominal burning sensation. Results: All the 108 patients completed the treatment and 12 patients were lost. Hp eradication rates in OACX group were 92.9% (26/28), 85.7% (24/28) in OMCX group, 66.7% (18/27) in OAC group and 60.0% (15.0%) in OMC group / 25) There was significant difference between the 4 groups (P <0.01). Symptomatic improvement: All the four groups were effective in improving the symptoms of upper abdominal pain, acid reflux and burning sensation of abdomen on the first day of treatment. However, the total score of OACX group and OMCX group decreased significantly than that of OAC and OMC Group (P <0.05 ~ 0.01). Conclusion: OACX group and OMCX group have a very high eradication rate of Hp. The OACX and OMCX groups are an effective regimen for Hp eradication in China. Moreover, OACX and OMCX alleviate the symptoms of patients with duodenal ulcer. OACX and OMCX group is also excellent