兰索拉唑与阿莫西林治疗幽门螺杆菌(HP)168例相关性十二指肠溃疡疗效观察(1)
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【摘要】目的 观察兰索拉唑与阿莫西林治疗幽门螺杆菌(HP)相关性十二指肠溃疡(DU)疗效。方法 把168例患者随机分成两组，治疗组用兰索拉唑合用阿莫西林，对照组用奥美拉唑合用和阿莫西林治疗HP及分别应用兰索拉唑、奥美拉唑维持治疗。治疗后观察临床症状、HP根除、溃疡愈合及复发。结果 治疗后临床症状缓解率、溃疡的近期愈合率、HP根除率，兰索拉唑治疗组分别为100%、90.4%、82.1%；奥美拉唑对照组分别97.6%、88%、80%；两组对比无显著性差异(P>0.05)。溃疡复发率：兰索拉唑停药组45%，维持组7%；奥美拉唑停药组52%，维持组23.5%，4组停药组及维持组之间，复发率的差异有非常显著性(P<0.01)。结论 兰索拉唑合用阿莫西林治疗HP相关性DU具有药物剂量小、副作用少、疗效高、复发率低等优点，值得推广应用。
【关键词】兰索拉唑 阿莫西林 十二指肠溃疡 幽门螺杆菌
中图分类号：R573.12文献标识码：A文章编号：1005-0515(2011)8-010-02
The observation of Lansoprazole and Amoxicillin in the treatment of 168 patients with Helicobacter pylori associated Duodenal Ulc
SU Yong
(Sichuan Yibin City, First People's Hospital Emergency Department, Sichuan Yibin 644000)
【Abstract】Objective To observe the efficacy of Lansoprazole and Amoxicillin in the treatment of 168 patients with Helicobacter pylori(HP) associated Duodenal Ulcer. Methods 168 patients were randomly divided into two groups. Lansoprazole and Amoxicillin were used in the treatment group, and Omeprazole and Amoxicillin were used in the control group. After completed, the clinical symptoms, HP eradication, ulcer healing and recurrence were observed. Results After treatment, Remission rate of clinical symptoms, recent ulcer healing rates and HP eradication rate in the treatment group were 100%, 90.4%, 82.1%; They were 97.6%, 88%, 80% in the control group. There were no significant difference between two groups(P>0.05). But there were significant difference between the ulcer recurrencete rate of two groups. Conclusion Lansoprazole and Amoxicillin in the treatment of HP associated Duodenal Ulcer has the advantage of smaller drug dose,less side effects and high efficacy, low relapse rate.
【Keywords】Lansoprazol Amoxicillin Duodenal Ulcer Helicobacter pylori
越来越多的流行病学研究表明：除外非甾体类抗炎药(NSAID)所致的溃疡，几乎所有溃疡，尤其十二指肠球部溃疡均可查到HP感染的证据，同时越来越多的临床研究也表明：溃疡病的复发与HP的未根除或再感染有关。根除幽门螺杆菌(HP)后可以显著地减少十二指肠溃疡的复发，此点已为世人所公论。兰索拉(Lansoprazole)是继奥美拉唑(omeprazole)以后问世的胃壁细胞氢离子—钾离子—三磷酸腺苷酶(H+—K+—ATP酶)质子泵抑制剂，抑制壁细胞泌酸的最终步骤，故抑酸彻底。本文报道应用兰索拉唑合用阿莫西林与奥美拉唑合用和阿莫西林抗HP治疗进行比较，及分别应用兰索拉唑、奥美拉唑维持治疗方法进行比较，治疗168例十二指肠溃疡观察其近期(4周)愈合率及1年复发率。
1 病例与方法
1.1 病例选择
所有病人均选自2006年3月-2008年6月在我院门诊及住院病人168例，均符合下列标准：①经胃镜证实的十二指肠溃疡活动期患者；②能明确判别有HP感染，即2种检测HP方法均阳性为HP阳性，均阴性为HP阴性；阴性和一阴一阳者不列为选择对象；③排除伴有幽门梗阻、复合性溃疡、多发性溃疡及卓一艾综合征；④2个月内无服过激素及非甾体类抗炎药；⑤非孕妇和哺乳期妇女；⑥心肺肝肾无严重疾病 ......
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