铋剂四联疗法联合双岐三联活菌对Hp感染患者的疗效

为了对比分析2种含铋剂四联疗法联合双岐三联活菌胶囊分别对幽门螺杆菌(Helicobacter pylori,Hp)感染患者疗效的影响。本研究随机选取200例就诊的Hp感染患者,将患者随机分为4组,每组50例。A组(埃索美拉唑,克拉霉素,阿莫西林,枸橼酸铋钾胶囊)、B组(埃索美拉唑,呋喃唑酮,阿莫西林,枸橼酸铋钾胶囊)、C组(埃索美拉唑,克拉霉素,阿莫西林,枸橼酸铋钾胶囊,双歧杆菌三联活菌胶囊)和D组(埃索美拉唑,呋喃唑酮,阿莫西林,枸橼酸铋钾胶囊和双歧杆菌三联活菌胶囊)。分析对比四组患者的临床缓解疗效、幽门螺旋杆菌根除效率、不良反应、复发情况及成本效果比。研究表明:2种含铋剂四联疗法联合双岐三联活菌胶囊对幽门螺杆菌感染患者的临床缓解症状、幽门螺杆菌根除率效果、不良反应发生率和复发情况效果优于含铋剂四联疗法,但是D组成本效果比更具有经济学优势。埃索美拉唑、呋喃唑酮、阿莫西林、枸橼酸铋钾胶囊和双歧杆菌三联活菌胶囊联合可促进Hp患者恢复,根除率高,降低不良反应和复发率,且具有经济学优势,值得推广应用。     

老年幽门螺杆菌相关性消化溃疡的临床特征及治疗方案研究

目的:分析研究老年幽门螺杆菌相关性消化溃疡的临床特征及治疗方案。方法:收集本院收治的240例老年消化性溃疡的患者,检查后按照Hp分组,则Hp阳性组患者206例,Hp阴性组患者36例,比较两组的年龄、溃疡部位、胃泌素和生长抑素水平。之后,将Hp阳性组患者等分为实验组和对照组,每组各103例,实验组给予埃索美拉唑三联疗法,对照组给予奥美拉唑三联疗法,治疗结束后评定临床效果。结果:Hp阳性组年龄和十二指肠溃疡率比Hp阴性组显著高,而胃溃疡率和生长抑素水平显著低(p0.05)。实验组和对照组Hp根除率、溃疡愈合率和不良反应发生率无明显差异(p0.05),但是临床症状消失时间实验组明显短于对照组(p0.05)。结论:老年幽门螺杆菌相关性消化溃疡的患者中,十二指肠溃疡的发病率高与胃溃疡,埃索美拉唑治疗消化性溃疡,临床症状消失快,值得临床推广。     

埃索美拉唑三联疗法治疗复发性消化性溃疡临床对比研究

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)阳性复发性消化性溃疡的临床疗效.方法:将90例经内镜诊断并检测证实Hp阳性的复发性消化性溃疡患者随机分为两组.A组(45例):埃索美拉唑20 mg 羟氨苄青霉素l g 黄连素300 mg,每日2次,共7 d;B组(45例):奥美拉唑20 mg 羟氨苄青霉素1 g 克拉霉素500 mg,每日2次,共7 d.疗程结束4周后复查胃镜并检测Hp,观察腹痛缓解率、溃疡愈合率、Hp根除率及用药后的不良反应等.结果:埃索美拉唑组第1天和第2天腹痛缓解率分别为34.6%和59.6%,高于奥美拉唑组的17.3%和38.5%(P＜0.05 o埃索美拉唑组和奥美拉唑组溃疡愈合率分别为92-3%和88.5%,Hp根除率分别为88.5%和82.7%,差异无显著性(P＞0.05).两组用药后不良反应少,有较好的安全性.结论:埃索美拉唑三联疗法治疗Hp阳性的复发性消化性溃疡安全有效,腹痛缓解速度优于奥美拉唑三联疗法.     

溃疡散合并西药治疗幽门螺杆菌相关消化性溃疡疗效观察

目的:观察溃疡散合并西药治疗幽门螺杆菌相关消化性溃疡的疗效.方法:将幽门螺杆菌相关消化性溃疡患者126例随机分为试验组和对照组,分别接受溃疡散合并雷尼替丁、阿莫西林和三联疗法(埃索关拉唑、克拉霉素和阿莫西林)治疗,疗程结束后从临床症状评分、胃镜表现和幽门螺杆菌根除率三方面评价其疗效.结果:试验组症状评分显著低于对照组(P＜0.05),胃镜表现和幽门螺杆菌根除率方面两组无显著性差异.结论:溃疡散合并雷尼替丁、阿莫西林治疗幽门螺杆菌相关消化性溃疡效果良好,溃疡散能够显著改善症状,无显著副作用.     

埃索美拉唑治疗幽门螺杆菌阳性十二指肠球部溃疡疗效观察

目的:比较埃索美拉唑与兰索拉唑、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疗效观察。方法:将84例Hp阳性的十二指肠球部溃疡随机分为三组。埃索美拉唑组(28例):埃索美拉唑20mg+阿莫西林1g+呋喃唑酮100mg,每日2次,共7日,后服用埃索美拉唑20mg,每日一次,共21天;兰索拉唑组(28例):兰索拉唑15mg+阿莫西林1g+呋喃唑酮100mg,每日2次,共7日,后服用兰索拉唑15mg,每日一次,共21天;奥美拉唑组(28例):奥美拉唑20mg+阿莫西林1g+呋喃唑酮100mg,每日2次,共7日,后服用奥美拉唑20mg,每日一次,共21天。疗效结束4周后复查胃镜并检测Hp,观察腹痛缓解率、溃疡愈合率,Hp根治率及药物不良反应。结果:埃索美拉唑组、兰索拉唑组和奥美拉唑组溃疡愈合率分别为100%,85.7%,82.1%,HP根治率为85.7%,60.7%,64.3%,埃索美拉唑组溃疡愈合率及Hp根除率高于兰索拉唑组及奥美拉唑组,差异具有统计学意义(P<0.05)。兰索拉唑组及奥美拉唑组溃疡愈合率及Hp根除率无明显差异(P>0.05)。三组用药后不良反应少,具较好的安全性。结论:埃索美拉唑三联疗法治疗Hp阳性的消化性溃疡疗效优于兰索拉唑及奥美拉唑三联疗法,值得临床广泛应用。     

埃索美拉唑为基础的四联疗法对消化性溃疡患者幽门螺杆菌根除率、炎性因子及生活质量的影响

目的:探讨埃索美拉唑为基础的四联疗法对消化性溃疡(PU)患者幽门螺杆菌(Hp)根除率、炎性因子及生活质量的影响。方法:选取2016年3月～2018年11月间我院接收的117例PU患者,根据数表法将患者随机分为对照组(n=58)和研究组(n=59),对照组给予以奥美拉唑为基础的四联疗法治疗,研究组给予以埃索美拉唑为基础的四联疗法治疗,比较两组患者临床疗效、Hp根除率、炎性因子、生活质量及不良反应。结果:研究组治疗后总有效率为74.58%(44/59),高于对照组患者的53.45%(31/58)(P0.05)。两组患者治疗后白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)较治疗前降低,且研究组低于对照组(P0.05)。研究组的HP根除率高于对照组(P0.05)。两组患者治疗后临床症状、心理情感、社交及任务完成评分均较治疗前升高,且研究组高于对照组(P0.05)。两组不良反应发生率比较无统计学差异(P0.05)。结论:埃索美拉唑为基础的四联疗法治疗PU,可有效改善炎性因子水平、Hp根除率和生活质量,疗效确切,安全性好,临床应用价值较高。     

埃索美拉唑治疗幽门螺杆菌阳性十二指肠球部溃疡疗效观察

目的：比较埃索关拉唑与兰索拉唑、奥美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性十二指肠球部渍疡疗效观察。方法：将84例Hp阳性的十二指肠球部溃疡随机分为三组。埃索美拉唑组（28例）：埃索美拉唑20mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用埃索美拉唑20mg,每日一次,共21天;兰索拉唑组（28例）：兰索拉唑15mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用兰索拉唑15mg,每日一次,共21天;奥美拉唑组（28例）：奥美拉唑20mg＋阿莫西林1g＋呋喃唑酮100mg,每日2次,共7日,后服用奥美拉唑20mg,每日一次,共21天。疗效结束4周后复查胃镜并检测Hp,观察腹痛缓解率、溃疡愈合率,Hp根治率及药物不良反应。结果：埃索美拉唑组、兰索拉唑组和奥关拉唑组溃疡愈合率分别为100％,85．7％,82．1％,HP根治率为85．7％,60．7％,64.3％,埃索美拉唑组溃疡愈合率及Hp根除率高于兰索拉唑组及奥美拉唑组,差异具有统计学意义（P〈0．05）。兰索拉唑组及奥美拉唑组溃疡愈合率及Hp根除率无明显差异（P〉0．05）。三组用药后不良反应少,具较好的安全性。结论：埃索关拉唑三联疗法治疗Hp阳性的消化性溃疡疗效优于兰索拉唑及奥美拉唑三联疗法,值得临床广泛应用。     

埃索美拉唑与奥美拉唑治疗老年反流性食管炎的临床疗效及其经济学评价

目的:对比分析埃索美拉唑与奥美拉唑在治疗老年反流性食管炎(RE)的临床疗效及其经济学价值。方法:采用随机数字表法将我院2013年2月至2014年8月消化科门诊治疗的84例老年RE患者分成埃索美拉唑组与奥美拉唑组,每组患者42例。两组患者分别给予埃索美拉唑与奥美拉唑治疗,对比分析两组治疗第4、8周的临床症状和食管炎病变,对治疗方案进行成本(C)-效果(E)分析。结果:两组治疗第8周的临床有效率、食管炎愈合率和总有效率均显著高于第4周(P0.05);其中埃索美拉唑组第4周和第8周的临床有效率均显著高于奥美拉唑组(P0.05);埃索美拉唑组治疗第8周的食管炎愈合率和食管炎总有效率均显著高于奥美拉唑组(P0.05);埃索美拉唑组4周、8周治疗的C/E值均低于奥美拉唑组。结论:埃索美拉唑在治疗老年RE的临床疗效上优于奥美拉唑,且C/E较低,临床上具有较高的经济学价值。     

四联疗法治疗幽门螺杆菌阳性胃溃疡的疗效观察

目的：观察埃索美拉唑联合瑞巴派特、阿莫西林、克拉霉素治疗幽门螺杆菌阳性胃溃疡临床疗效。方法：60例确诊的Hp阳性胃溃疡患者随机分为对照组（30例）和治疗组（30例）,其中对照组患者给予奥美拉唑＋阿莫西林＋克拉霉素三联法治疗,实验组给予埃索美拉唑＋瑞巴派特＋阿莫西林＋克拉霉素四联法治疗。观察比较两组患者临床症状缓解情况,溃疡愈合率、Hp根除率及溃疡复发率。结果：①经过治疗,所有患者腹痛、腹胀、反酸、暧气等临床症状积分均显著降低（P〈0.01）,且治疗组下降程度大于对照组,两组间差异有统计学意义（P〈0.05）。②治疗组患者痊愈率为60.00%、总有效率为93.33%,明显高于对照组痊愈率（43.33%）和总有效率（80.00%）,两组间差异有统计学意义（P〈0.05）。③治疗组S2期获得率、溃疡愈合率和Hp根除率分别为93.33%、96.67%和93.33%,显著高于对照组60.00%的S2期获得率、70.00%的愈合率和83.33%的根除率（P〈0.01或0.05）。④随访1年后,治疗组患者溃疡复发率为11.54%,与对照组32.00%的复发率比较差异有显著性（P〈0.05）。结论：四联疗法治疗幽门螺杆菌阳性胃溃疡可有效缓解患者临床症状,提高溃疡愈合质量,根除Hp感染,减少复发,效果优于三联疗法。     

益生菌辅助埃索美拉唑镁四联疗法对幽门螺杆菌阳性十二指肠溃疡患者肠道菌群分布及血清IFN\|γ、IL\|10的调节作用

目的探讨益生菌辅助埃索美拉唑镁四联疗法在幽门螺杆菌(H.pylori)阳性十二指肠溃疡中的应用价值。方法按照随机数字表将我院116例H.pylori阳性十二指肠溃疡患者(2017年12月至2019年2月收治)分为观察组与对照组,各58例。对照组患者给予常规埃索美拉唑镁四联疗法治疗,观察组患者于对照组基础上联合益生菌(双歧杆菌三联活菌胶囊)辅助治疗,两组患者均治疗4周。对比两组患者临床疗效、治疗前后肠道菌群(双歧杆菌、乳杆菌)数量及血清免疫炎症介质[干扰素-γ(IFN-γ)、白细胞介素-10(IL-10)]水平、H.pylori根除率及治疗安全性。结果 (1)观察组患者治疗有效率为93.10%(54/58),显著高于对照组的79.31%(46/58)。(2)治疗后两组患者肠道双歧杆菌、乳杆菌数量较治疗前增加,且观察组高于对照组(均P0.05)。(3)治疗后两组患者血清IFN-γ、IL-10水平均较治疗前降低,且观察组低于对照组(均P0.05)。(4)观察组患者H.pylori根除率为91.38%(53/58),显著高于对照组的70.69%(41/58)。(5)治疗期间观察组不良反应发生率为12.07%(7/58),与对照组的13.79%(8/58)比较差异无统计学意义(χ~2=0.077,P=0.782)。结论益生菌辅助埃索美拉唑镁四联疗法治疗H.pylori阳性十二指肠溃疡患者效果确切,有利于提高H.pylori根除率,其机制可能与其能改善肠道菌群分布、下调血清免疫炎症介质表达有关。     

布拉氏酵母菌散剂联合三联疗法对 儿童幽门螺杆菌感染的治疗

目的观察布拉氏酵母菌散剂联合以质子泵抑制剂(PPI)为基础的标准三联疗法对儿童幽门螺杆菌(H.pylori)感染的疗效,以探索根除率高且不良反应少的H.pylori根除方案。方法采用前瞻性随机对照研究,从确诊为H.pylori感染的患儿中选取120例作为研究对象,再随机分为布拉氏组和标准三联疗法组,每组各60例。标准三联疗法组口服阿莫西林[50mg/(kg·d),饭后分两次服]、克拉霉素[20mg/(kg·d),饭后分两次服]和奥美拉唑[0.7～0.8mg/(kg·d),饭前半小时一次服完]治疗,布拉氏组在标准三联疗法的基础上加服布拉氏酵母菌散剂(250mg/次,2次/d)。两组患者均治疗14d,由患儿家属记录治疗过程中发生不良反应的情况。停药后4周内不再口服任何抗生素,后行14 C呼气试验以评估H.pylori根除情况。比较两组患者根除率及不良反应发生率。结果治疗后三联疗法组H.pylori根除率为76.7%(46/60),布拉氏组为90.0%(54/60),二者差异有统计学意义(P0.05)。治疗过程中布拉氏组患者腹泻发生率低于三联疗法组,差异有统计学意义(P0.05)。结论布拉酵母联合三联疗法能提高H.pylori的根除率,降低治疗过程中的不良反应。     

双歧四联活菌多药联合对根除幽门螺杆菌患者的临床疗效观察

目的:研究双歧四联活菌多药联合对根除幽门螺杆菌(Helicobacter pylori,Hp)患者的临床疗效。方法:从2012年3月到2013年3月,共计60例病患因腹部不适就诊。以数字法随机分成实验组及对照组。对照组以埃索美拉唑镁肠溶片(剂量为20 mg bid)和胶体酒石酸铋钠(剂量为165 mg qid)以及克拉霉素片(剂量为0.5 bid)和阿莫西林胶囊(剂量为1.0 bid)等药物治疗。实验组则在对照组基础之上另以双歧四联活菌(剂量为1.5 tid)药物治疗。对比两组疗效和治疗后不良反应,以及治疗依从性情况。结果:实验组的根除率为86.67%(26/30),显著高于对照组的63.33%(19/30);未根除率为13.33%(4/30),显著低于对照组的36.67%(11/30)。实验组有不良反应者8例,占比26.67%,显著少于对照组的17例,占比56.67%;实验组在治疗后的依从性为好者占比90.00%(27/30),显著高于对照组的66.67%(20/30),依从性为差者占比10.00%(3/30),显著低于对照组的33.33%(10/30),差异均有统计学意义(均P0.05)。结论:双歧四联活菌采用多药联合方式可明显提升对于Hp的根除率,同时减少不良反应,增加病患依从性。效果显著,值得临床推荐。     

复方嗜酸乳杆菌片联合三联方案根除幽门螺杆菌的临床研究

目的探讨复方嗜酸乳杆菌片联合三联方案根除幽门螺杆菌(Helicobacter pylori,H.pylori)的疗效及不良反应。方法将143例H.pylori检测阳性的患者随机分为A1组(48例)、A2组(46例)和B组(49例)。B组给予三联方案(埃索美拉唑、阿莫西林、克拉霉素)根除H.pylori治疗,疗程10d。A1组、A2组分别在上述三联方案的基础上同时加用10d、20d的复方嗜酸乳杆菌片。治疗过程中观察并记录上述三组的不良反应发生情况,停药4周后查13 C呼气试验判别H.pylori根除是否成功。结果共133例患者完成治疗和随访,A1组、A2组、B组根除率按方案(PP)分析分别为65.9%、69.8%、63.0%,按意向性(ITT)分析分别为60.4%、65.2%、59.2%,无论按方案分析还是意向性分析三组根除率差异均无统计学意义(P0.05)。纳入三组的共143例患者均完成不良反应的随访,A1组、A2组、B组不良反应发生率分别为10.4%、8.7%、30.6%,三组相比差异有统计学意义(P0.05),其中A1组、A2组分别与B组相比差异有统计学意义(P0.05),A1组与A2组相比差异无统计学意义(P0.05)。结论三联方案加用10d、20d的复方嗜酸乳杆菌片未能提高H.pylori根除率,但可降低不良反应发生率。     

Efficacy of moxifloxacin-based triple therapy as second-line treatment for Helicobacter pylori infection

BACKGROUND AND AIM: Metronidazole and tetracycline-based second-line quadruple therapy, widely used for Helicobacter pylori infection, often ends up in failure due to antibiotic resistance and poor compliance in Korea. Our aim is to evaluate the efficacy and tolerability of moxifloxacin-based triple therapy as an alternative second-line treatment for H. pylori infection. METHODS: The subjects consisted of 85 patients infected with H. pylori, in whom initial proton pump inhibitor triple therapy had failed. They were randomized to receive the following 7-day therapy: 1, moxifloxacin 400 mg q.d., esomeprazole 20 mg b.i.d., and amoxicillin 1 g b.i.d.; and 2, esomeprazole 40 mg b.i.d., tripotassium dicitrate bismuthate 300 mg q.i.d., metronidazole 500 mg t.i.d., and tetracycline 500 mg q.i.d. Eradication rates, drug compliance, and side-effect rates of each group were evaluated. RESULTS: The eradication rates were 75.6 and 83.8% with moxifloxacin triple therapy, and 54.5 and 72.7% with quadruple therapy by intention-to-treat (p = .042) and per-protocol analyses (p = .260), respectively. Moxifloxacin triple therapy was significantly superior to quadruple therapy in terms of side-effect rates (p = .039). Compliance for therapy, i.e., the percentage of tablets taken (> 85%), was 90.2 and 75.0%, numerically higher in moxifloxacin triple therapy group than in quadruple therapy group, but without statistical difference (p = .065). CONCLUSIONS: Moxifloxacin-based triple therapy showed high eradication rates with few side effects and good drug compliance, suggesting this regimen could be a safe and effective option as second-line therapy for H. pylori infection in Korea.     

Bismuth-Containing Quadruple Therapy as Second-Line Treatment for Helicobacter pylori Infection: Effect of Treatment Duration and Antibiotic Resistance on the Eradication Rate in Korea

Background:  The eradication rate of first-line Helicobacter pylori treatment is only 70–85% and has been decreasing due to the increase in antibiotic resistance. The aim of this study was to evaluate the efficacy of bismuth-containing quadruple therapy as second-line treatment for H. pylori infection based on treatment duration.
Methods:  We prospectively enrolled 227 patients that were found to have persistent H. pylori infection after first-line proton-pump inhibitor-clarithromycin-amoxicillin triple therapy. Patients were randomized to 1-week (112 patients) and 2-week (115 patients) quadruple therapy with tripotassium dicitrate bismuthate 300 mg q.i.d., meteronidazole 500 mg t.i.d., and tetracycline 500 mg q.i.d. and esomeprazole 20 mg b.i.d. The eradication rate, drug compliance, and adverse events were compared based on treatment duration.
Results:  The eradication rates were 72/112 (64.3%, 95% CI: 0.504–0.830) and 71/92 (77.2%, 0.440–0.749) with 1-week group, and 95/115 (82.6%, 1.165–2.449) an 88/94 (93.6%, 1.213–5.113) with 2-week group by intention-to-treat therapy ( p  = .002) and per-protocol analysis ( p  = .001), respectively. The adverse events increased as the treatment durations increased from 7 to 14 days (20.0 and 42.5%, respectively, p  < .001). However, there was no significant difference in the patient compliance or the rate of major adverse events between the 1- and 2-week groups (6.3 and 12.5%, respectively, p  = .133).
Conclusion:  Two-week bismuth-containing quadruple therapy was more effective than the 1-week treatment, and should be considered for second-line treatment in Korea.     

Second-line treatment for Helicobacter pylori infection: 10-day moxifloxacin-based triple therapy versus 2-week quadruple therapy

BACKGROUND AND AIM: The aim of this study was to test the efficacy of 10-day moxifloxacin-based triple therapy versus 2-week quadruple therapy for the second-line treatment of Helicobacter pylori infection. METHODS: One hundred and ninety-two patients who had failed previous H. pylori eradication on standard triple therapy were randomized to one of two regimens: 1, moxifloxacin (400 mg q.d.), amoxicillin (1000 mg b.i.d.), and esomeprazole (20 mg b.i.d.) for 10 days (the 10MEA group), or 2, esomeprazole (20 mg b.i.d.), tripotassium dicitrate bismuthate (300 mg q.i.d.), metronidazole (500 mg t.i.d.), and tetracycline 500 mg (q.i.d.) for 14 days (the 14EBMT group). The eradication rates, drug compliances, and side-effect rates of these two regimens were compared. RESULTS: Eradication rates by intention-to-treat and per-protocol analyses in the 10MEA and 14EMBT groups were 71.9% and 82.6%, and 71.7% and 90.5% (p = .973 and .321), respectively. The 10MEA group was significantly superior to the 14EMBT group in terms of side-effect rates (12.2% vs. 39.6%, p = .001), and discontinuation rates due to side-effects were lower in the 10MEA group than in the 14EMBT group (0.7% vs. 13.2%, p < .001). Moreover, compliance was higher in the 10MEA group (94.2% (131/139)) than in the 14EBMT group (83.0% (44/53)) (p = .014). CONCLUSION: The 10-day moxifloxacin-based triple therapy was found to have a high eradication rate with few side-effects and good drug compliance. These findings suggest that this regimen is a safe and effective second-line treatment option for H. pylori infection in Korea.     

Rabeprazole- versus esomeprazole-based eradication regimens for H. pylori infection

BACKGROUND: Different kinds of proton pump inhibitor-based triple therapies could result in different Helicobacter pylori eradication rates. AIM: The aims of this study were to compare the efficacy and safety of rabeprazole- and esomeprazole-based triple therapy in primary treatment of H. pylori infection in Taiwan. PATIENTS AND METHODS: From June 2005 to March 2007, 420 H. pylori-infected patients were randomly assigned to receive a 7-day eradication therapy with either esomeprazole 40 mg daily (EAC group, n = 209) or rabeprazole 20 mg b.i.d. (RAC group, n = 211) in combination with amoxicillin 1 g b.i.d. and clarithromycin 500 mg b.i.d.. Follow-up endoscopy with biopsy was done 12-16 weeks after completion of eradication therapy. Those who refused endoscopic exams underwent (13)C-urea breath test to assess the treatment response. RESULTS: Intention-to-treat analysis revealed that the eradication rate was 89.4% in the EAC group and 90.5% in RAC groups (p-value = .72). All of the subjects returned for assessment of compliance (100% in EAC group vs. 99.5% in RAC group, p-value = .32) and adverse events (3.83% in EAC group vs. 6.16% in RAC group, p-value = .27). Sixty (28.7%) and 37 (17.6%) patients in EAC and RAC group, respectively, refused endoscopy and underwent a (13)C-urea breath test to determine the treatment effect. CONCLUSION: In conclusion, rabeprazole- and esomeprazole-based primary therapies for H. pylori infection are comparable in efficacy and safety.     

Double-dose, new-generation proton pump inhibitors do not improve Helicobacter pylori eradication rate

BACKGROUND: Up to present, omeprazole plus two antibiotics are used for Helicobacter pylori eradication therapy . Few studies have compared double-dose new-generation, proton pump inhibitors (PPI) with omeprazole. Therefore, we conducted a randomized, prospective study to evaluate differences in H. pylori eradication rates by PPI type. MATERIAL AND METHODS: Between January 2006 and December 2006, 576 consecutive patients with proven H. pylori infection were enrolled prospectively. Four different PPIs [omeprazole 20 mg b.i.d. (old generation), or pantoprazole 40 mg b.i.d., rabeprazole 20 mg b.i.d., or esomeprazole 40 mg b.i.d. (new generation)] were added to clarithromycin (500 mg b.i.d.) and amoxicillin (1 g b.i.d.) for 1 week. RESULTS: By intention-to-treat analysis, no difference was found between the eradication rates of these four PPIs: 64.9% (omeprazole, n = 148), 69.3% (pantoprazole, n = 140), 69.3% (rabeprazole, n = 140), and 72.9% (esomoprazole, n = 148). When eradication rates were analyzed according to whether patients had an ulcer or not on a per-protocol basis, no difference was found between the eradication rates of the four PPIs. However, side-effects were more common in the esomeprazole-based triple therapy group than in the other groups (p < .05). CONCLUSIONS: No convincing evidence was obtained that double-dose new-generation PPIs have better H. pylori eradication rates and tolerability than omeprazole.     

阿泰宁在根除幽门螺杆菌中的临床应用疗效

目的探讨阿泰宁（酪酸梭菌活菌胶囊）在根除幽门螺杆菌中的应用和临床疗效。方法将120例幽门螺杆菌阳性的慢性胃炎患者,随机分为观察组（58例）和对照组（62例）。对照组口服标准三联方（雷贝拉唑肠溶胶囊＋阿莫西林胶囊＋克拉霉素缓释片）进行治疗,观察组在口服三联方的同时序贯联用阿泰宁（即先服用三联方,间隔2~3 h后再服用阿泰宁）,疗程均为1周,观察两组患者用药后幽门螺杆菌根除率及不良反应发生率。结果 （1）幽门螺杆菌根除率：对照组为72.6%,观察组为91.4%,观察组明显高于对照组,差异有统计学意义（P〈0.05）;（2）不良反应发生率：对照组为38.7%;观察组为8.6%,观察组明显低于对照组,差异有统计学意义（P〈0.05）。结论在标准三联方的基础上加用阿泰宁能显著提高幽门螺杆菌根除率,并减少胃肠道不良反应,提高患者的依从性,值得临床推广。