Buzás György M, Székely E, Illyés G, Széles I
Gasztroenterológia, Ferencvárosi Egészségügyi Szolgálat, Budapest.
Orv Hetil. 2000 Jul 30;141(31):1711-4.
The aim of this study was to compare in an open, controlled and prospective trial the efficacy of one-week regimen using either lansoprazole (2 x 30 mg) + 2 x 500 mg metronidazole + 2 x 250 mg clarithromycin (group I, 60 cases) or ranitidine bismuth citrate (2 x 400 mg) + 2 x 500 mg metronidazole + 2 x 250 mg clarithromycin (group II, 61 cases) on the eradication of Hp infection in duodenal ulcer patients. The diagnosis was stated endoscopically. Hp infection was confirmed from 2 antral + 2 corporeal biopsies by the modified Giemsa stain and rapid urease test. After eradication the patients were given on-demand treatment with 30 mg lansoprazole (group I) or 2 x 150 mg ranitidine (group II). Control 13C-urea breath test was performed 4-6 weeks after eradication. On intention to treat basis, Hp was eradicated in 78.3% (confidence interval, CI: 67.6-89.1%) in group I and 78.7% (CI: 68.1-89.2%) in group II (p > 0.05). Per protocol eradication rates were 92.1% (CI: 84.5-99.7%) in group I and 90.5 (CI: 82.4-98.6%) in group II (p > 0.05). Side effects were recorded in 13.5% in group I and 18.3% of cases in group II. Short term triple therapies using either lansoprazole or ranitidine bismuth citrate + 2 antimicrobials were effective and safe in the eradication of Hp in duodenal ulcer patients.
本研究的目的是在一项开放、对照和前瞻性试验中,比较使用兰索拉唑(2×30毫克)+2×500毫克甲硝唑+2×250毫克克拉霉素的一周治疗方案(第一组,60例)与枸橼酸铋雷尼替丁(2×400毫克)+2×500毫克甲硝唑+2×250毫克克拉霉素的一周治疗方案(第二组,61例)对十二指肠溃疡患者幽门螺杆菌(Hp)感染的根除效果。通过内镜检查做出诊断。通过改良吉姆萨染色和快速尿素酶试验,从2块胃窦活检组织和2块胃体活检组织中确认Hp感染。根除治疗后,给予第一组患者按需服用30毫克兰索拉唑,给予第二组患者按需服用2×150毫克雷尼替丁。在根除治疗后4至6周进行13C尿素呼气试验对照。在意向性治疗的基础上,第一组中78.3%(置信区间,CI:67.6 - 89.1%)的患者Hp被根除,第二组中78.7%(CI:68.1 - 89.2%)的患者Hp被根除(p>0.05)。按照方案分析,第一组的根除率为92.1%(CI:84.5 - 99.7%),第二组为90.5%(CI:82.4 - 98.6%)(p>0.05)。第一组13.5%的患者和第二组18.3%的患者记录到有副作用。使用兰索拉唑或枸橼酸铋雷尼替丁+2种抗菌药物的短期三联疗法在根除十二指肠溃疡患者的Hp方面有效且安全。