雷贝拉唑、克拉霉素、阿莫西林三联疗法治疗幽门螺杆菌相关性溃疡

目的:评估雷贝拉唑、克拉霉素、阿莫西林三联疗法治疗幽门螺杆菌(Helicobacter pylori,Hp)相关性溃疡的疗效。方法:86例经胃镜检查确诊,并经快速尿素酶法和组织学测定为Hp阳性的消化性溃疡病人,随机分为雷贝拉唑组(46例)和奥美拉唑组(40例)。两组分别予以三联疗法:雷贝拉唑20 mg或奥美拉唑20 mg,bid;克拉霉素0.5 g,bid;阿莫西林1.0 g,bid,连用10 d,记录用药后病人症状缓解程度。疗程结束后4周,复查胃镜并检测Hp。结果:雷贝拉唑组第1、3天症状缓解率分别为65.2%和93.5%;奥美拉唑组为20.0%和45.0%,两组差异有显著性(P<0.05)。雷贝拉唑组溃疡治愈率为95.7%,奥美拉唑组为72.5%,两组比较差异有显著性(P<0.05)。雷贝拉唑组Hp根除率为93.5%,奥美拉唑组为90.0%,两组比较无统计学差异(P>0.05)。结论:雷贝拉唑三联疗法治疗Hp相关性溃疡,溃疡愈合迅速、症状消失快,与奥美拉唑组比较,雷贝拉唑组在症状缓解率及溃疡愈合方面更具优势。     

雷贝拉唑治疗十二指肠球部溃疡的临床疗效

目的:探讨雷贝拉唑加阿莫西林及替硝唑治疗十二指肠球部溃疡的临床疗效.方法:将145例幽门螺杆菌(Hp)阳性的十二指肠球部溃疡患者按确诊时间随机分为两组,治疗组(n=75)口服雷贝拉唑10 mg,bid,1周后10 mg,qd,疗程3周;阿莫西林1.0 g,bid,疗程1周;替硝唑0.5 g,bid,疗程1周.对照组(n=70)口服法莫替丁20mg,bid,疗程5周;枸橼酸铋钾110 mg,tid,疗程5周;阿莫西林1.0 g,bid,疗程2周;替硝唑0.5 g,bid,疗程2周.疗程结束后复查胃镜来判断其溃疡愈合率、Hp根除率和临床症状的改善情况.结果:治疗组和对照组镜下溃疡痊愈分别为72例和57例(96%和81.4%,P<0.01);Hp根除率分别为90.7%和71.4%(P<0.01).治疗组显效73例(97.3%),有效2例(2.7%),总有效率为100%;对照组显效45例(64.2%),有效19例(27.1%),总有效率91.3%,治疗组显效率和总有效率显著高于对照组(P <0.01).两组均无明显的不良反应.结论:雷贝拉唑能有效促进溃疡愈合,快速缓解疼痛,与抗生素联合应用能提高Hp的根除率.     

贝拉唑与奥美拉唑三联疗法治疗十二指肠球部溃疡的疗效比较

目的 探讨新型质子泵抑制药雷贝拉唑肠溶片三联疗法对十二指肠球部溃疡的疗效和幽门螺杆菌(Hp)根除率的影响. 方法 将65例Hp阳性的十二指肠球部溃疡患者分成治疗组37例, 对照组28例, 治疗组口服雷贝拉唑片10 mg, 阿莫西林胶囊1 g, 克拉霉素500 mg, bid, 7 d后, 继续口服雷贝拉唑片10 mg, bid, 连服7 d. 对照组口服奥美拉唑肠溶胶囊20 mg, 阿莫西林胶囊1 g, 克拉霉素500 mg, bid, 7 d后, 继续口服奥美拉唑胶囊20 mg, bid, 连服7 d. 疗程结束4周后复查胃镜并检测Hp, 观察两组十二指肠球部溃疡的愈合率和Hp的根除率, 同时于用药后第1, 2, 3, 7, 14天观察临床症状的改善情况. 结果 62例患者完成试验, 治疗组失访2例, 对照组失访1例. 治疗组的十二指肠球部溃疡愈合率为91.4%(32/35), Hp根除率为82.9%(29/35), 对照组分别为88.9%(24/27)和81.5%(22/27), 差异无显著性 (P>0.05). 治疗组第1天和第2天症状缓解率分别为45.7%和68.6%, 高于对照组的14.8%和37%(均P<0.05), 两组不良反应发生率分别为5.7%和7.4%. 结论 两组治疗方案均能有效清除Hp和缓解症状, 并有较高的溃疡愈合率.     

雷贝拉唑三联疗法治疗消化性溃疡的疗效观察

目的 观察雷贝拉唑三联疗法治疗消化性溃疡的临床疗效.方法 将92例消化性溃疡患者随机分为治疗组和对照组各46例.治疗组先给予雷贝拉唑10mg、阿莫西林1.0g、克拉霉素500mg;对照组先给予奥美拉唑20mg、阿莫西林1.0g、克拉霉素500mg,2组均每天2次,饭前1h服用,连服7d.然后治疗组单独给予雷贝拉唑10mg,对照组单纯给予奥美拉唑20mg,2组均每天1次,连服7d.治疗后比较2组溃疡愈合率、幽门螺杆菌(Hp)根除率,并观察2组不良反应发生情况.结果 治疗组溃疡愈合率为91.30%高于对照组的60.04%,差异有统计学意义(P＜0.01).2组不良反应均轻微,可自行消失.结论 雷贝拉唑三联疗法是一种短程、高效、安全的根除Hp及促进溃疡愈合的方案.     

雷贝拉唑三联疗法根除幽门螺杆菌感染

目的　观察雷贝拉唑三联短程疗法根除幽门螺杆菌及治疗十二指肠溃疡的疗效。方法　 12 0例经胃镜检查确诊为十二指肠溃疡并经快速尿素酶实验和病理学检查确定为Hp阳性的病人随机分为两组 :雷贝拉唑组和奥美拉唑组。两组先予以三联疗法 :雷贝拉唑 10mg或奥美拉唑 2 0mg、阿莫西林 1g及克拉霉素 5 0 0mg ,每日 2次 ,连续 7d ,然后予雷贝拉唑 10mg或奥美拉唑 2 0mg ,每天 1次 ,连续 7d ,疗程结束后 4周复查胃镜并检测Hp ,并记录用药后病人症状的改变程度。结果　 113例完成治疗方案。其中雷贝拉唑组Hp根除率为 93 0 % ,奥美拉唑组为 85 7% ,两组间差异无显著意义 (P >0 0 5 ) ;雷贝拉唑组 2周溃疡愈合率为 94 7% ,奥美拉唑组为 78 6 % ,雷贝拉唑组明显高于奥美拉唑组 ,两组差异有显著意义 (P <0 0 5 ) ;雷贝拉唑组第 1、3d症状缓解率分别为 70 1%、91 2 % ,奥美拉唑组为 39 3%、6 7 8% ,两组比较差异有显著意义 (P<0 0 5 )。结论　雷贝拉唑、克拉霉素和阿莫西林三联短程疗法能有效根除Hp及高溃疡愈合率 ,并能迅速缓解症状 ,与奥美拉唑三联疗法相比较 ,在Hp根除率上差异无显著意义 ,在 2周溃疡愈合率及症状缓解率方面 ,雷贝拉唑要明显优于奥美拉唑。     

雷贝拉唑与奥美拉唑三联疗法治疗消化性溃疡疗效比较

目的比较雷贝拉唑三联疗法与奥美拉唑三联疗法治疗幽门螺杆菌(H.pylori,Hp)阳性消化性溃疡的疗效。方法80例经胃镜检查确诊为消化性溃疡并经快速尿素酶实验和病理学检查确定为Hp阳性的患者随机分为两组。观察组40例:口服雷贝拉唑10 mg,克拉霉素0.5 g,阿莫西林1 g,2次/d,治疗1周后单独服用雷贝拉唑10 mg,1次/d,连续1周。对照组40例:口服奥美拉唑20 mg,克拉霉素0.5 g,阿莫西林1 g,2次/d,治疗1周后单独服用奥美拉唑20 mg,1次/d,治疗1周,疗程结束后4周复查胃镜并检测Hp,并记录用药后患者症状的改变程度。结果观察组4周溃疡愈合率为95%,对照组为77.5%,观察组明显高于对照组,两组差异有显著意义(P<0.05);观察组Hp根除率为87.5%,对照组为75%,两组间差异无显著意义(P>0.05);雷贝拉唑组第1、3天症状缓解率分别为82.5%、92.5%,奥美拉唑组为62.5%、72.5%,两组比较差异有显著意义(P<0.05)。结论两组方案均能有效治疗消化性溃疡和缓解临床症状,并能有效地根除幽门螺杆菌。但雷贝拉唑三联疗法在快速改善临床症状和促进溃疡愈合方面优于奥美...     

雷贝拉唑三联用药治疗幽门螺杆菌感染的临床疗效

目的:观察雷贝拉唑联合克拉霉素和阿莫西林治疗幽门螺杆菌(Hp)感染性溃疡的临床疗效。方法:将252例Hp阳性的消化性溃疡患者随机分为雷贝拉唑治疗组和奥美拉唑对照组,两组联合的抗菌药均为克拉霉素和阿莫西林,疗程1周。各组在治疗前1周内和治疗后4~8周分别检测Hp感染情况,记录用药前后的症状,并观察溃疡的愈合情况。结果:雷贝拉唑治疗组Hp根除率(93.18%)明显高于奥美拉唑对照组(78.33%)(P<0.05),两组溃疡愈合率比较差异无显著性(P>0.05);症状缓解率方面,雷贝拉唑要明显优于奥美拉唑。结论:雷贝拉唑联合克拉霉素和阿莫西林短程疗法能有效清除Hp及高溃疡愈合率,能迅速缓解症状,是根除Hp比较有效的治疗方案。     

拉唑类三联疗法根除幽门螺杆菌感染的临床观察

目的:通过与奥美拉唑(omeprazole,O)三联疗法比较,观察兰索拉唑(lansoprazole,L)和雷贝拉唑(rabeprazole,R)三联疗法根除幽门螺杆菌(Hp)和治疗十二指肠溃疡的疗效.方法:121例患者分为3组:兰索拉唑(LFC组,41例)和雷贝拉唑试验组(RFC组,40例)和奥美拉唑对照组(OFC组,40例).3组均先给予三联治疗:兰索拉唑30 mg,雷贝拉唑10 mg,奥美拉唑20 mg 呋喃唑酮(furazolidone,F)100 mg 克拉霉素(clarithromycin,C)250 mg,bid,连续7 d.然后,单独给予兰索拉唑30 mg、雷贝拉唑10 mg或奥美拉唑20 mg,qd,连续14 d,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l,2,3,7,21,35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:110例患者完成全部治疗方案,11例失访.LFC组的Hp根除率为91.9%,RFC组为91.4%,OFC组为89.5%,3组间差异无显著性(P>0.05).结论:3组治疗方案均能有效地根除Hp.但是,缓解十二指肠溃疡患者的症状,兰索拉唑、雷贝拉唑较奥美拉唑为优.     

雷贝拉唑治疗消化性溃疡及清除幽门螺杆菌感染的近期疗效

目的 :观察雷贝拉唑治疗消化性溃疡的临床疗效及对幽门螺杆菌 (Hp)感染的清除率。方法 :116例消化性溃疡病人 ,其中雷贝拉唑组 4 6例 ,给雷贝拉唑 10mg ,po ,bid(或 qd) ;奥美拉唑组 70例 ,给奥美拉唑 2 0mg ,po ,bid(或 qd)。若Hp(+ ) ,同时给予杀菌治疗 1wk。观察治疗前后症状积分的变化 ,疗程结束时 ,复查胃镜观察溃疡的愈合情况。结果 :雷贝拉唑组治疗 4 (6 )wk后主要临床症状积分为 (18.4± 1.3)分 ,与治疗前 (74± 6 )分相比 ,P <0 .0 1,与奥美拉唑组相比 ,P >0 .0 5 ;溃疡的愈合率96 % ,与奥美拉唑组相比 ,P <0 .0 1。Hp清除率雷贝拉唑组为 93% ,奥美拉唑组为 89% ,P >0 .0 5。结论 :雷贝拉唑能明显缓解消化性溃疡症状 ,止痛效果快 ,对溃疡有较高的愈合率及Hp清除率。     

雷贝拉唑三联疗法治疗消化性溃疡的疗效观察

目的观察雷贝拉唑三联疗法治疗消化性溃疡的临床疗效。方法将92例消化性溃疡患者随机分为治疗组和对照组各46例。治疗组先给予雷贝拉唑10mg、阿莫西林1.0g、克拉霉素500mg;对照组先给予奥美拉唑20mg、阿莫西林1.0g、克拉霉素500mg,2组均每天2次,饭前1h服用,连服7d。然后治疗组单独给予雷贝拉唑10mg,对照组单纯给予奥美拉唑20mg,2组均每天1次,连服7d。治疗后比较2组溃疡愈合率、幽门螺杆菌(Hp)根除率,并观察2组不良反应发生情况。结果治疗组溃疡愈合率为91.30%高于对照组的60.04%,差异有统计学意义(P<0.01)。2组不良反应均轻微,可自行消失。结论雷贝拉唑三联疗法是一种短程、高效、安全的根除Hp及促进溃疡愈合的方案。     

贡子泵抑制剂三联疗法治疗十二指肠球部溃疡的效果观察

目的研究质子泵抑制剂三联疗法治疗十二指肠球部溃疡的效果。方法选择80例经胃镜检查确诊Hp阳性的十二指肠球部溃疡患者,随机分为A组40例、B组40例,A组用兰索拉唑30mg,qd×4周,克拉霉素0．5g,bid×1周,阿莫西林1．0g,bid×1周;B组用法莫替丁20mg,bid×4周,克拉霉素0．5g,bid×1周,阿莫西林1．0g,bid×1周。疗程（4周）结束后,复查胃镜并做^14C呼气试验及快速尿素酶试验,比较两组的溃疡愈合率、Hp根除率。结果A、B组的溃疡愈合率分别为95．0％、82．5％,Hp根除率为92．5％、70．0％。A、B两组的溃疡愈合率、Hp根除率比较,差异有统计学意义（P〈0．05）。结论兰索拉唑二三联疗法能有效根除Hp,是治疗十二指肠球部溃疡比较理想的方法。     

埃索美拉唑三联与奥美拉唑三联治疗Hp阳性十二指肠溃疡的对比研究

目的:比较埃索美拉唑三联与奥美拉唑三联疗法治疗幽门螺杆菌(Hp)阳性十二指肠球部溃疡的临床疗效。方法:将124例经内镜诊断并检测证实Hp阳性的十二指肠球部溃疡患者随机分为两组。埃索美拉唑组(62例):埃索美托唑20mg加阿莫西林lg加克拉霉素500mg,每日2次,共7天;奥美拉唑组(62例):奥美拉唑20mg加阿莫西林1g加克拉霉素500mg,每日2次,共7天。疗程结束4周后胃镜检查并检测Hp,观察腹痛缓解率、溃疡愈合率、Hp根除率及药物不良反应。结果:埃索美拉唑组第一天和第二天腹痛缓解率分别为35.8%和60.2%,高于奥美托唑组的16.5%和40.3%(P<0.05)。埃索美托唑组和奥美拉唑组溃疡愈合率分别为93.6%和89.5%,Hp根除率分别为87.9%和83.7%,差异无显著性(P>0.05)。两组药物不良反应少,有较好的安全性。结论:埃索美托唑三联疗法治疗Hp阳性的十二指肠溃疡安全有效。腹痛状缓解速度明显优于奥美拉唑三联疗法。     

Triple therapy with clarithromycin, omeprazole, and amoxicillin for eradication of Helicobacter pylori in duodenal ulcer patients in Asia and Africa

BACKGROUND: Studies assessing the efficacy of triple therapy containing clarithromycin and amoxicillin for the eradication of Helicobacter pylori infection and healing of duodenal ulcers in Asian and African countries are limited. AIM: To determine the efficacy and safety of 1-week triple therapy with omeprazole, amoxicillin and clarithromycin for eradicating H. pylori infection in patients with active duodenal ulcer living in Asian and African regions. METHODS: This was an open-label, multicentre study in 11 centres in Asia and Africa. Patients with endoscopy-proven duodenal ulcer and who were H. pylori-positive were treated with clarithromycin 500 mg, omeprazole 20 mg, and amoxicillin 1000 mg, all given twice daily for 7 days. Upper endoscopy was repeated at week 6 to check for ulcer healing and H. pylori status. RESULTS: A total of 117 patients were recruited. H. pylori eradication rates were 85% by per protocol analysis and 80% by intention-to-treat analysis. Ulcer healing was found in 94% of subjects (per protocol analysis). Clinical success, measured by change of pre-treatment ulcer symptoms, was strongly supported by complete resolution or improvement in 100% of the evaluable patients (per protocol analysis). Since treatment-related adverse events, when present, were largely mild or moderate, the triple therapy regimen was considered safe. CONCLUSION: Seven-day triple therapy with omeprazole, amoxicillin, and clarithromycin was efficacious for treating Asian and African patients with duodenal ulcer disease associated with H. pylori infection, and the treatment regimen was well-tolerated.     

雷贝拉唑四联疗法治疗良性胃溃疡43例

目的 观察雷贝拉唑四联疗法治疗幽门螺旋杆菌(HP)阳性良性胃溃疡的临床疗效.方法 选择86例HP阳性良性胃溃疡患者,将其随机分为治疗组和对照组,各43例.治疗组口服雷贝拉唑10 mg,枸橼酸铋雷尼替丁350 mg,阿莫西林1 000 mg,呋喃唑酮100 mg,均2次/天,共4d.对照组口服奥美拉唑20 mg,阿莫西林1 000 mg,克拉霉素500 mg,均2次/天,共7d.抗HP治疗后继续服用雷贝拉唑10 mg或奥美拉唑20 mg,1次/天,疗程4周.观察治疗后4周时的HP根除率、溃疡愈合率及随访半年、1年时的HP再感染率和溃疡复发率.结果 治疗4周后,治疗组和对照组HP根除率分别为95.35％和76.74％,差异有统计学意义(P＜0.05);溃疡愈合率分别为93.02％和88.37％,差异无统计学意义(P＞0.05).治疗组和对照组随访半年HP再感染率分别为7.50％和23.68％,溃疡复发率分别为5.00％和21.05％,差异均有统计学意义(P＜0.05);随访1年HP再感染率分别为12.50％和42.11％,溃疡复发率分别为10.00％和36.84％,差异均有统计学意义(P＜0.05).结论 雷贝拉唑和枸橼酸铋雷尼替丁组成的四联疗法是一种短程、高效、安全的根除HP和促进溃疡愈合的方法.     

Rabeprazole-based 3-day and 7-day triple therapy vs. omeprazole-based 7-day triple therapy for the treatment of Helicobacter pylori infection

BACKGROUND: Rabeprazole is a new proton pump inhibitor with more potent acid suppressive and anti-Helicobacter effects. AIM: To compare two different regimens of rabeprazole-based triple therapy vs. 7-day omeprazole-based triple therapy for the eradication of Helicobacter pylori infection. METHOD: Patients with proven H. pylori infection were randomized to receive: (i) 7-day rabeprazole, 10 mg, amoxicillin, 1000 mg, and clarithromycin, 500 mg, all twice daily; (ii) 3-day rabeprazole, 20 mg, amoxicillin, 1000 mg, and clarithromycin, 500 mg, all twice daily; or (iii) 7-day omeprazole, 20 mg, amoxicillin, 1000 mg, and clarithromycin, 500 mg, all twice daily. Endoscopy (CLO test, histology) was performed before randomization and 6 weeks after drug treatment. RESULTS: One hundred and seventy-three patients were randomized. H. pylori eradication rates (intention-to-treat, n=173/per protocol, n=167) were 88%/91% for 7-day rabeprazole-based therapy, 72%/72% for 3-day rabeprazole-based therapy and 82%/89% for 7-day omeprazole-based therapy, respectively. The per protocol eradication rate was significantly better in the 7-day rabeprazole-based therapy and 7-day omeprazole-based therapy groups when compared to the 3-day rabeprazole-based therapy group (P=0.01 and P=0.04, respectively). Compliance was excellent and all three regimens were well tolerated. CONCLUSIONS: The efficacy of seven-day rabeprazole-based triple therapy is similar to 7-day omeprazole-based triple therapy for the eradication of H. pylori infection.     

High eradication rates of Helicobacter pylori with a new sequential treatment

BACKGROUND: Eradication rates of Helicobacter pylori with standard triple therapy are disappointing, and studies from several countries confirm this poor performance. AIM: To assess the eradication rate of a new sequential treatment regimen compared with conventional triple therapy for the eradication of H. pylori infection. METHODS: One thousand and forty-nine dyspeptic patients were studied prospectively. H. pylori-infected patients were randomized to receive 10-day sequential therapy [rabeprazole (40 mg daily) plus amoxicillin (1 g twice daily) for the first 5 days, followed by rabeprazole (20 mg), clarithromycin (500 mg) and tinidazole (500 mg) twice daily for the remaining 5 days] or standard 7-day therapy [corrected] [rabeprazole (20 mg), clarithromycin (500 mg) and amoxicillin (1 g) twice daily]. H. pylori status was assessed by histology, rapid urease test and 13C-urea breath test at baseline and 6 weeks or more after completion of treatment. RESULTS: Higher eradication rates were found with the sequential regimen compared to the standard regimen (intention-to-treat: 92% vs. 74%, P < 0.0001; per protocol: 95% vs. 77%, P < 0.0001). Higher eradication rates were also seen in patients with peptic ulcer disease and non-ulcer dyspepsia. In both treatments, compliance was similar (> 90%), as was the rate of side-effects, which were mild. CONCLUSIONS: This 10-day sequential treatment regimen achieves high eradication rates in peptic ulcer disease and non-ulcer dyspepsia.     

艾普拉唑三联治疗幽门螺杆菌阳性十二指肠溃疡的近期疗效

目的：比较艾普拉唑与埃索美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性十二指肠溃疡（DU）的近期疗效。方法：120例却阳性的DU患者随机分为3组,分别给予艾普拉唑15mg、20mg、埃索美拉唑20mg,同时给予克拉霉素0．5g、阿莫西林1．0g,bid,共10d。根除t／p结束后3组患者分别继续给予相应剂量质子泵抑制药治疗4周,于2周末和4周末复查胃镜并检测三和,观察患者溃疡愈合率、Hp根除率及药品不良反应。结果：2周末3组溃疡愈合率分别为82．5％、75％、77．5％（P〉0．05）;4周末溃疡愈合率分别为90％、87．5％、87．5％（P〉0．05）。3组Hp根除率分别为85％、82．5％、90％（P〉0．05）。3组均未见严重不良反应。结论：艾普拉唑三联疗法治疗Hp阳性DU能有效缓解症状,促进溃疡愈合,安全有效,疗效与剂量无明显线性关系,与埃索美拉唑临床疗效差异不明显。     

雷贝拉唑+克拉霉素+左氧氟沙星三联疗法治疗幽门螺杆菌消化道溃疡的观察

目的：观察雷贝拉唑＋克拉霉素＋左氧氟沙星三联疗法治疗幽门螺杆菌消化道溃疡的疗效。方法：60例幽门螺杆菌阳性消化道溃疡患者随机平分为两组,两组患者都采用三联一周疗法,治疗组为雷贝拉唑＋克拉霉素＋左氧氟沙星治疗,对照组为奥美拉唑＋阿莫西林＋甲硝唑治疗。结果：经过治疗,治疗组30例96.7%的总有效率明显高于对照组70.0%的总有效率（P＜0.05）;治疗组90.0%的HP根除率明显高于对照组66.7%的HP根除率（P＜0.05）。结论：雷贝拉唑＋克拉霉素＋左氧氟沙星三联疗法治疗幽门螺杆菌消化道溃疡能提高疗效,提高HP根除率,值得推广应用。