短程四联疗法对幽门螺杆菌阳性十二指肠溃疡的疗效探讨

目的 :观察铋剂、四环素、甲硝唑合并雷尼替丁的短程四联疗法对幽门螺杆菌 (Hp)阳性十二指肠溃疡的疗效。方法 :经胃镜确诊为十二指肠溃疡的患者用枸橼酸铋 2 2 0mg ,甲硝唑 40 0mg ,四环素 5 0 0mg和雷尼替丁3 0 0mg ,每日 2次口服 ,疗程 7d。治疗结束后 4周复查胃镜 ,观察十二指肠球部溃疡愈合率和Hp根除率。同期的对照组用不含雷尼替丁的三联疗法 (枸橼酸铋 2 2 0mg ,甲硝唑 40 0mg ,四环素 5 0 0mg)每日 2次 ,疗程 2周。结果 :四联疗法的Hp根除率 91.0 % ,高于三联疗法对照组的 81.2 %。二组溃疡愈合率分别为 94.6%和 93 .7% ,比较差异无显著性 (P >0 .0 5 )。而两组副反应发生率为 4/ 5 6例 (7.1% )和 19/ 48例 (3 9.5 % ) ,比较差异有显著性 (P <0 .0 5 )。结论 :雷尼替丁合用铋剂、甲硝唑、四环素治疗 7d的Hp根除率 >90 % ,副反应少 ,依从性较好 ,且价格低廉 ,是临床上较为理想的治疗方案

Short- term quadruple therapy for the treatment of duodenal ulcer with H. pylori infection

Objective: To determine the efficacy of short-term quadruple therapy with colloidal bismuth subcitrate,tetracycline,metronidazole and ranitidine in curing duodenal ulcer with Helicobacter pylori(Hp).Methods: Patients with duodenal ulcer and Hp infection were randomed to receive the 1-wk quadruple therapy (colloidal bismuth subcitrate 220mg bid, metronidazole 400mg bid, mtetracycline 500mg bid, ranitidine 300mg bid) or 2-wk triple therapy(colloidal bismuth subcitrate 220mg bid, metronidazole 400mg bid, mtetracycline 500mg bid).Endoscopy was repeated 5 wk after randomization to assessed ulcer healing and Hp eradication.Results: Quadruple therapy achieved 94.6%(53/56)of Hp eradication rate and 91.0% (51/56)of ulcer healing rate, slightly higher then those in triple (93.7%,81.2%, respectively),which was not statistically significant ( P >0.05).There was significant difference in the incidence of side effect in quadruple group (7.1%)and that in triple group(39.5%), P <0.05.Conclusion: Despite similar efficacy in ulcer healing, the quadruple therapy is safer and more effective than triple therapy in healing Hp infection. Quadruple therapy have better compliance and a lower cost than triple therapy.