国产奥美拉唑治疗消化性溃疡的疗效研究

目的研究国产奥美拉唑对消化性溃疡的疗效。方法对112例经内镜确诊的消化性溃疡患者随机分为两组,其中试验组80例,对照组32例,分别予以奥美拉唑及进口洛赛克口服,试验组第一周每日2次,每次20mg,第二～四周,每日1次,每次20mg,十二指肠溃疡一疗程为28d,胃溃疡一疗程为56d,对照组服用方法,剂量和疗程同试验组,两组在治疗过程均予使用抗幽门螺杆菌感染药物2周。结果试验组溃疡愈合率为58.75%,显效率为27.5%,总有效率86.25%;对照组溃疡愈合率59.38%。显效率为31.25%,总有效率为90.63%,两组在治疗消化性溃疡有效率方面均差异无统计学意义(P>0.05)。结论国产奥美拉唑是治疗消化性溃疡的有效药物。     

洛赛克及克拉霉素联合治疗消化性溃疡的临床应用研究

目的本研究旨在评价洛赛克及克拉霉素联合治疗消化性溃疡的临床应用价值。方法将确诊为幽门螺旋杆菌阳性的消化性溃疡患者120例随机分组为2组：治疗组60例，予以洛赛克20mg、克拉霉素250mg，2次／d，疗程2周；对照组50例，予以雷尼替丁300mg、呋喃唑酮100mg，2次／d，疗程2周。患者在治疗期间停用其他抗酸药，戒烟、禁酒。在治疗前后观察血、尿常规及肝、肾功能，疗程结束1周内复查胃镜，评价疗效。结果治疗组中胃溃疡的愈合率和总有效率分别为97．45％和100．00％，十二指肠溃疡的愈合率和总有效率分别为89．12％和96．00％；对照组中胃溃疡的愈合率和总有效率分别为81．01%和89．43％，十二指肠溃疡的愈合率和总有效率分别为59．23％和76．23％。治疗组中疼痛消失率在胃溃疡为93．5％，在十二指肠溃疡则为93．1％；对照组中疼痛消失率在胃溃疡为90．9％，在十二指肠溃疡则为88．8％。2组在愈合率、总有效率方面比较差异有统计学意义（P〈0．05），疼痛消失率方面比较差异无统计学意义（P〉0．05）。结论洛赛克及克拉霉素联合应用能提高治疗消化性溃疡的疗效，能较好的改善症状，值得在临床推广。     

康复新液胃镜喷洒并口服治疗消化性溃疡56例

目的：探索康复新液对消化性溃疡愈合速度及质量的影响.方法：胃溃疡88例,十二指肠溃疡15例,复合性溃疡9例,随机分成两组：A组奥美拉唑胶囊20mg/次,2次/d;胶体果胶胶囊200mg/次,3次/d;克拉霉素分散片250m/g次,3次/d;B组在A组的基础上,康复新液10ml/次,3次/d,疗程1月.观察溃疡愈合情况、临床症状改善情况及副反应,并进行统计学处理.结果：A、B组胃溃疡治疗后总有效率分别为76.79%、92.86%,B组临床疗效优于A组,差异有统计学意义（P〈0.05）,两组副反应均少见.结论：康复新液联合奥美拉唑、胶体果胶铋、克拉霉素治疗消化性溃疡,能加快溃疡愈合速度,提高创面修复质量,具有疗效高,副反应少等优点.     

泮托拉唑治疗消化性溃疡临床疗效观察

目的：研究泮托拉唑与奥美拉唑治疗消化性溃疡的疗效及安全性。方法：经胃镜证实的消化性溃疡患者随机分成泮托拉唑组（治疗组）62例和奥美拉唑组（对照组）58例。治疗组泮托拉唑40mg,po,qn,对照组用药为奥美拉唑20mg,po,qn。十二指肠溃疡患者疗程4周,胃溃疡患者疗程6周。停药后均复查胃镜观察溃疡愈合情况。症状改善及副作用发生情况。结果：十二指肠溃疡的愈合率两组分别为92．1％和94．7％,胃溃疡的愈合率两组分别为91．7％和90％（P均〉0．05）。各项症状的改善情况两组无统计学差异。副作用的发生率两组分别为9．7％和8．6％（P〉0．05）。结论：泮托拉唑对消化性溃疡有较高的治愈率和良好的症状改善情况,其疗效和副作用与奥美拉唑相当。     

兰索拉唑治疗84例消化性溃疡疗效观察

目的评估兰索拉唑和奥美拉唑联用抗生素2周治疗84例HP阳性的消化性溃疡的疗效。方法将84例HP阳性的消化性溃疡患者随机分为治疗组和对照组,每组42例。A组口服兰索拉唑片30mg,1次/d,连用4～6周,阿莫西林1.0g+克拉霉素500g2次/d,连用7d。B组口服奥美拉唑20mg2次/d,连用14d,阿莫西林1.0g+克拉霉素500g2次/d,连用7d。在治疗过程中,两组均按研究方案记录症状缓解情况和不良反应,用药结束后4～6周复查胃镜,了解HP根除率和溃疡愈合率。结果治疗组、对照组HP根除率分别为90%、80%(P>0.05),溃疡愈合率分别为92%、67%(P<0.01),均无不良反应发生。结论兰索拉唑2周三联疗法是一种短程、安全、高效的根除HP及促进溃疡愈合的方案。     

甘露聚糖肽联合泮托拉唑、克拉霉素治疗消化性溃疡的临床疗效观察

目的 观察甘露聚糖肽胶囊联合泮托拉唑、克拉霉素治疗消化性溃疡的临床疗效。方法 采用随机对照的方法治疗胃镜检查确诊的消化性溃疡患者共89例，其中甘露聚糖肽胶囊联合泮托拉唑、克拉霉素联合用药组（试验组）46例，其中胃溃疡26例，十二指肠溃疡20例；单纯泮托拉唑钠胶囊与克拉霉素组（对照组）43例，其中胃溃疡20例，十二指肠溃疡23例。结果 试验组中胃溃疡的愈合率和总有效率分别为96．15％和100．00％，十二指肠溃疡的愈合率和总有效率分别为85．00％和95．00％；对照组中胃溃疡的愈合率和总有效率分别为75．00％和85．00％，十二指肠溃疡的愈合率和总有效率分别为69．57％和82．610k；试验组中疼痛消失率在胃溃疡为92．310k，在十二指肠溃疡则为90．00％。对照组中疼痛消失率在胃溃疡为85．00％，在十二指肠溃疡则为86．96％。两组在愈合率、总有效率方面比较差异有统计学意义（P〈0．05），疼痛消失率消失率方面比较差异无统计学意义（P〉0．05）。结论 具有促进创伤组织修复的免疫增强剂能提高治疗消化性溃疡的临床效果，是一种值得推广的治疗方法。     

埃索美拉唑治疗幽门螺旋杆菌相关性消化性溃疡

目的:观察埃索美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:98例消化性溃疡患者,其中埃索美拉唑组48例,给埃索美拉唑20mg,Po,bid,共1周,安慰剂3周;奥美拉唑组50例,给奥美拉唑20mg,Po,bid,共3周。疗程结束时,复查胃镜观察溃疡的愈合情况。结果:埃索美拉唑组胃溃疡腹痛消失时间为(2.8±1.2)d,十二指肠溃疡为(1.8±0.5)d;奥美拉唑组分别为(3.8±1.9)d和(2.6±1.0)d,经统计学处理有显著性差异(P<0.01)。溃疡的愈合率和HP清除率,与奥美拉唑组70%和60%相比(P<0.01),埃索美拉唑组分别为95.8%和91.7%。结论:埃索美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。     

甘珀酸钠联合奥美拉唑治疗消化性溃疡的疗效观察

目的探讨甘珀酸钠片联合奥美拉唑肠溶胶囊治疗消化性溃疡的临床疗效。方法选取2016年6月—2017年6月湖北医药学院附属人民医院收治的消化性溃疡患者102例作为研究对象,采取随机数字表法将所有患者分为对照组和治疗组,每组各51例。对照组口服奥美拉唑肠溶胶囊,40 mg/次,2次/d。治疗组在对照组治疗的基础上饭后口服甘珀酸钠片,第1周80 mg/次,3次/d,之后50 mg/次,3次/d。两组患者均连续治疗4周。观察两组的临床疗效,比较两组的溃疡愈合时间、临床症状消失时间。结果治疗后,对照组、治疗组总有效率分别为84.31%、96.08%,两组总有效率比较差异有统计学意义(P0.05)。治疗后,治疗组十二指肠溃疡、胃溃疡、复合溃疡愈合时间明显短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组溃疡痛、烧心、反酸消失时间均明显短于对照组,两组比较差异具有统计学意义(P0.05)。结论甘珀酸钠片联合奥美拉唑肠溶胶囊治疗消化性溃疡临床疗效显著,能加快溃疡面愈合,改善临床症状,值得在临床推广应用。     

奥美拉唑治疗Hp阳性溃疡25例疗效观察

目的观察奥美拉唑两周疗法治疗Hp阳性消化性溃疡的疗效。方法对经胃镜诊断,Hp阳性的消化性溃疡25例患者用奥美拉唑两周疗法,进行临床观察。结果临床治愈率96%,Hp根除率90%,溃疡愈合率85%。结论此种方法治疗幽门螺旋杆菌阳性的消化性溃疡是非常有效的。     

三联疗法联合治疗小儿幽门螺杆菌相关性消化性溃疡的疗效观察

目的：评价奥美拉唑,羟氨苄青霉素,甲硝唑三联疗法对幽门螺旋杆菌（HP）相关性消化性溃疡的疗效。方法：将85例HP阳性的胃溃疡和（或）十二指肠溃疡患随机分为二组：第一组43例,每次口服奥美拉唑0．6－0．8mg/kg.d,甲硝唑18mg/kg.d,均每日2次,羟氨苄青霉素40mg/kg.d,每日4次,2周为1疗程,第二组为42例,给药方式同第一组,只是疗程缩短为1周,疗程结束后每日服用奥美拉唑0．6－0．8mg/kg.d,持续1周,疗程结束达4周时复查胃镜及HP,结果：第一组因过敏性皮疹5例而退出观察,38例进行统计学分析,第一组和第二组的HP根除率分别为89．4％和83．3％,十二指肠溃疡和胃溃疡的愈合率分别为92．1％和88．1％,结论：第一组HP根除率和溃疡愈合率均高于第二组,但无显差异性（P＞0．05）,两组均有较理想的溃疡愈合率和HP根除率。     

Omeprazole in peptic ulcers resistant to histamine H2-receptor antagonists

Eighteen patients with duodenal, gastric or jejunal ulcers, resistant to at least 3 months treatment with histamine H2-receptor antagonists, singly or in combination with other anti-ulcer drugs, were treated with 40 mg omeprazole once daily for up to 8 weeks. All ulcers healed, the majority within two weeks. After ulcer healing patients were given maintenance therapy with high doses of cimetidine or ranitidine. Of 15 patients on maintenance therapy with H2-receptor antagonists, 12 (80%) developed a relapse after a period ranging from 3 to 52 weeks. Two patients were lost to follow-up. After re-healing on 40 mg omeprazole, two patients were given 20 mg omeprazole daily as maintenance therapy but relapses occurred again after 14 and 26 weeks respectively. After re-healing on 40 mg omeprazole, these two patients and one additional patient received maintenance therapy with 40 mg omeprazole daily. At present these three patients have been relapse-free for periods varying from 16 to 52 weeks. No side effects were registered during treatment with omeprazole. It is therefore concluded that omeprazole is highly effective in healing refractory peptic ulcers and that omeprazole maintenance therapy may be useful for prevention of relapse. Patients are sometimes seen with peptic ulceration which appears resistant to therapy with histamine H2-receptor antagonists, colloidal bismuth subcitrate, sucralfate or pirenzepine, either given as monotherapy for a prolonged period of time or as combination therapy. Usually the reason for such therapeutic failure remains obscure. Whether virtually total abolition of acid secretion will allow ulcer healing in these circumstances is unknown.(ABSTRACT TRUNCATED AT 250 WORDS)     

Omeprazole in the treatment of peptic ulcers resistant to H2-receptor antagonist

Thirty patients with peptic ulcers resistant to at least 8 weeks of continuous therapy with full-dose H2-receptor antagonists alone or followed by other anti-ulcer drugs, were treated with the gastric proton pump inhibitor omeprazole (40 mg), administered orally once daily for up to 8 weeks. The study design was non-comparative and open; healing was verified by endoscopy. After only 2 weeks of treatment, 21 out of 23 (91%) duodenal ulcer patients were healed, as well as 2 out of 2 patients with both duodenal and gastric ulcer and 1 out of 3 patients with prepyloric ulcer. After 4 weeks, all duodenal ulcers, 1 out of 2 gastric ulcers and 2 out of 3 pre-pyloric ulcers were healed. A further month of therapy healed the gastric ulcer to give an overall healing rate of 97% and leaving only one patient (pre-pyloric ulcer) unhealed at the end of the study. Of 19 patients suffering ulcer symptoms at entry, only two patients reported any symptoms at 2 weeks and one of these (who remained unhealed) continued to have symptoms throughout the study. One patient reported mild asthenia; otherwise, no clinical or biochemical side-effects were recorded. It is concluded that omeprazole is highly effective in healing refractory peptic ulcers.     

Omeprazole versus famotidine in the short-term treatment of duodenal ulcer disease

The efficacy and safety of omeprazole, in 241 patients with active recurrent duodenal ulcer from 21 Italian centres, was studied in a multicentre double-blind randomized trial comparing 20 mg omeprazole o.m. or 40 mg famotidine nocte with endoscopic examination, symptom recording, laboratory screening and gastrin assay. In a per protocol analysis, the duodenal ulcer healing rates for omeprazole and famotidine, documented by endoscopy, were 62% (68/109) and 33% (39/117) after 2 weeks of treatment (P less than 0.001), 92% (96/104) and 80% (86/108) cumulative after 4 weeks (P less than 0.05), and 99% (102/103) and 92% (96/104) after 6 weeks (P less than 0.05), respectively. The results of this trial demonstrate that 20 mg omeprazole o.m. is superior to 40 mg famotidine nocte in duodenal ulcer healing.     

Omeprazole (20 mg o.m.) versus ranitidine (150 mg b.d.) in duodenal ulcer healing and pain relief

The object of this double-blind, multicentre study was to compare duodenal ulcer healing rates after 2 to 4 weeks of treatment with either 20 mg omeprazole o.m. or 150 mg ranitidine b.d. One hundred and eighty-one patients were randomized: 91 received omeprazole and 90 received ranitidine. In a per protocol analysis at 2 weeks, 63% of the patients were healed on omeprazole and 65% of the patients were healed on ranitidine (N.S.); at 4 weeks 91% were healed in the omeprazole group and 96% were healed in the ranitidine group. There were no differences in ulcer symptom relief between the two groups. There were no significant changes in laboratory values in either of the groups. Adverse events were few and mainly mild and transient. We conclude that both omeprazole (20 mg o.m.) and ranitidine (150 mg b.d.) result in rapid, ulcer healing rates.     

Omeprazole. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in peptic ulcer disease and Zollinger-Ellison syndrome

Omeprazole is a substituted benzimidazole derivative which markedly inhibits basal and stimulated gastric acid secretion. It has a unique mode of action, irreversibly blocking the so-called proton pump of the parietal cell which is supposedly the terminal step in the acid secretory pathway. In animals, on a weight basis, omeprazole is 2 to 10 times more potent than cimetidine in inhibiting gastric acid secretion. Toxicological studies in rats have shown that very high doses of omeprazole administered for 2 years produce hyperplasia of gastric enterochromaffin-like cells and carcinoids, a few with proliferations into the submucosa. The significance of such findings to the clinical situation is wholly speculative and requires further research. Preliminary studies in patients with duodenal ulcers or Zollinger-Ellison syndrome have found no mucosal changes which would suggest that the drug represents a risk for development of carcinoid tumours at therapeutic dosages. In patients with duodenal ulcers omeprazole, at dosages of at least 20mg once daily, produced ulcer healing rates of between 60 and 100% after 2 weeks and between 90 and 100% after 4 weeks, even in patients resistant to treatment with H2-receptor antagonists. Comparative trials clearly demonstrated that omeprazole 20 to 40 mg administered once daily was significantly more effective than usual dosage regimens of cimetidine and ranitidine in healing duodenal ulcers during 2 to 4 weeks of treatment. At present no data are available evaluating omeprazole as maintenance therapy once ulcers have healed. Other clinical trials have also shown that omeprazole is effective for treating gastric ulcers, ulcerative peptic oesophagitis, and Zollinger-Ellison syndrome. In patients with Zollinger-Ellison syndrome the profound and long lasting antisecretory activity of omeprazole may make it the drug of choice for treating the massive acid hypersecretion associated with the disease, especially when H2-receptor antagonists are ineffective. During clinical trials reported to date omeprazole has been very well tolerated but further clinical experience is essential to fully evaluate its safety profile. Thus, omeprazole represents a pharmacologically unique antisecretory drug which is very effective for rapidly healing peptic ulcers and peptic oesophagitis, and for reducing gastric acid hypersecretion in patients with Zollinger-Ellison syndrome. If the apparent absence of undesirable mucosal morphological changes during treatment with usual doses in patients with peptic ulcer disease is confirmed, it may be a major advance in the treatment of these diseases.     

Is a one‐week course of triple anti‐Helicobacter pylori therapy sufficient to control active duodenal ulcer?

BACKGROUND: Triple therapy currently forms the cornerstone of the treatment of patients with Helicobacter pylori-positive duodenal ulcer. AIM: To establish whether prolonged antisecretory therapy is necessary in patients with active duodenal ulcer. METHODS: A total of 77 patients with H. pylori-positive duodenal ulcer were included in a prospective, controlled, double-blind study. All patients received a 7-day treatment with omeprazole 20 mg b.d., clarithromycin 500 mg b.d. and amoxicillin 1000 mg b.d. Patients in the omeprazole group underwent an additional 14-day therapy with omeprazole 20 mg; patients in placebo group received placebo. Endoscopy was performed upon inclusion in the study and after 3 and 8 weeks. RESULTS: Seventy-four patients were eligible for a per protocol analysis after 3 weeks, and 65 after 8 weeks. After 3 weeks, the healing rate was 89% in the omeprazole group and 81% in the placebo group (P=0.51). After 8 weeks, the ulcer healed in 97% of the patients in the total group (95% CI: 92.7-100%). H. pylori was eradicated in 88% of patients in the omeprazole group and in 91% in the placebo group (P=1.0). No statistically significant differences between the groups were found in ulcer-related symptoms or in ulcer healing. CONCLUSION: In patients with H. pylori-positive duodenal ulcer, a 7-day triple therapy alone is sufficient to control the disease.     

Comparison of pantoprazole versus omeprazole in the treatment of acute duodenal ulceration—a multicentre study

Methods: In this randomized, double-blind, multicentre study, the proton pump inhibitors pantoprazole and omeprazole were compared in patients with active duodenal ulcers. Two hundred and seventy-six protocol-correct patients received either pantoprazole 40 mg (n= 185) or omeprazole 20 mg (n= 91), once daily for 2 or 4 weeks, depending on the progress of ulcer healing. Results: Rates of complete ulcer healing after 2 weeks were 71% in patients given pantoprazole and 74% in patients given omeprazole. After 4 weeks the figures were 96% and 91%, respectively. These differences were not significant. There was no significant difference in ulcer pain prior to treatment, and 85% of the pantoprazole group and 86% on omeprazole were pain-free after 2 weeks (not significant). The time until complete pain relief with pantoprazole or omeprazole, based on data from diary cards, was not significantly different (P < 0.05, Uleman's U-test). Both treatments were equally well tolerated. Changes in routine laboratory parameters were minimal in both groups. Conclusion: Pantoprazole was shown to be a highly-effective and well-tolerated treatment for acute duodenal ulcer. Pantoprazole 40 mg and omeprazole 20 mg were equally effective with respect to ulcer healing and pain relief, and have similar adverse event profiles.     

Does eradication of Helicobacter pylori alone heal duodenal ulcers?

BACKGROUND: Eradication of Helicobacter pylori infection prevents duodenal ulcer (DU) relapse, but it remains uncertain whether eradication of H. pylori alone heals duodenal ulceration. AIM: To test the hypothesis that eradication of H. pylori infection is accompanied by healing of duodenal ulcer. METHODS: A total of 115 consecutive patients with endoscopically confirmed H. pylori-infected duodenal ulcer were randomly assigned to one of two groups. Group BTC patients received a 1-week course of colloidal bismuth subcitrate 220 mg b.d., tinidazole 500 mg b.d., clarithromycin 250 mg b.d. Group OBTC patients received omeprazole 20 mg daily for 4 weeks with the BTC regimen during the first week. Endoscopy with antral biopsies and 13C-urea breath test (UBT) were performed before and 4 weeks after completion of the 7-day triple or quadruple therapy. RESULTS: Eight patients dropped out (four in BTC and four in OBTC). Duodenal ulcer healing rates on an intention-to-treat basis in BTC and OBTC were 86% (95% CI: 77-95%) and 90% (95% CI: 82-98%), respectively. The eradication rates of H. pylori on an intention-to-treat basis in BTC and OBTC were 88% (95% CI: 79-96%) and 91% (95% CI: 84-99%), respectively. There were no statistically significant differences in ulcer healing rates and eradication rates between these two groups (P > 0.05). Epigastric pain resolved more rapidly in patients assigned to OBTC compared with those assigned to BTC. Both of the two regimens were well tolerated with only minor side-effects (3% of the 115 patients) and the compliance was good. CONCLUSIONS: BTC is a very effective H. pylori eradication regimen. Almost all duodenal ulcers heal spontaneously after cure of H. pylori infection using a 1-week low-dose bismuth-based triple therapy. Treating duodenal ulcer with simultaneous administration of omeprazole achieves ulcer pain relief more rapidly.