Chuang Chiao-Hsiung, Sheu Bor-Shyang, Kao Ai-Wen, Cheng Hsiu-Chi, Huang Ay-Huey, Yang Hsiao-Bai, Wu Jiunn-Jong
Department of Internal Medicine, Medical College, National Cheng Kung University, Tainan, Taiwan.
Hepatogastroenterology. 2007 Jan-Feb;54(73):320-4.
BACKGROUND/AIMS: To test the impact of vitamin C supplementation on triple therapy for H. pylori eradication.
A total of 171 H. pylori-infected patients were randomized to receive different one-week triple therapies, including 20 mg omeprazole, 1 g amoxicillin, plus the following twice daily: (1) 250 mg clarithromycin (C250 group, n=55); (2) 250 mg clarithromycin and 500 mg vitamin C (V-C250 group, n=61); (3) 500 mg clarithromycin (C500 group, n=55). Six weeks after treatment, the success of H. pylori eradication was assessed by a 13C-urea breath test. Each collected H. pylori strain was defined as either clarithromycin susceptible or resistant by E-test.
The demographic background, clarithromycin susceptibility of H. pylori, and drug compliance were similar among the three groups (p=NS). For clarithromycin susceptible infection, the V-C250 group had a higher eradication rate than the C250 group (ITT: 85% vs. 68% and PP: 90% vs. 73%, p = 0.03), but had an equivalent rate to the C500 group (p=NS). For clarithromycin resistant infection, all three groups had a similarly poor eradication rate of less than 34%.
Adding vitamin C to one-week triple therapy can reduce the dosage of clarithromycin, but preserve the high eradication efficacy for clarithromycin susceptible H. pylori infection.
背景/目的：测试补充维生素C对幽门螺杆菌根除三联疗法的影响。
总共171例幽门螺杆菌感染患者被随机分配接受不同的一周三联疗法，包括20毫克奥美拉唑、1克阿莫西林，以及以下每日两次的药物：（1）250毫克克拉霉素（C250组，n = 55）；（2）250毫克克拉霉素和500毫克维生素C（V-C250组，n = 61）；（3）500毫克克拉霉素（C500组，n = 55）。治疗六周后，通过13C-尿素呼气试验评估幽门螺杆菌根除的成功率。通过E-test将每个收集的幽门螺杆菌菌株定义为对克拉霉素敏感或耐药。
三组患者的人口统计学背景、幽门螺杆菌对克拉霉素的敏感性以及药物依从性相似（p =无显著差异）。对于克拉霉素敏感感染，V-C250组的根除率高于C250组（意向性分析：85%对68%，符合方案分析：90%对73%，p = 0.03），但与C500组相当（p =无显著差异）。对于克拉霉素耐药感染，所有三组的根除率均同样较差，低于34%。
在一周三联疗法中添加维生素C可减少克拉霉素的剂量，但对克拉霉素敏感的幽门螺杆菌感染仍保持高根除疗效。
