Graham D Y, Lew G M, Evans D G, Evans D J, Klein P D
Baylor College of Medicine, Houston, Texas.
Ann Intern Med. 1991 Aug 15;115(4):266-9. doi: 10.7326/0003-4819-115-4-266.
To determine whether antimicrobial therapy for Helicobacter pylori infection accelerates the healing of duodenal ulcers.
Single-blind, randomized, controlled trial.
Veterans Affairs hospital.
One hundred and five patients with endoscopically verified duodenal ulcers.
Patients received either ranitidine, 300 mg/d, or ranitidine, 300 mg/d, plus "triple therapy" (2 g/d of tetracycline, 750 mg/d of metronidazole, and 5 or 8 bismuth subsalicylate tablets per day). Triple therapy was administered for only the first 2 weeks of ulcer treatment.
Videoendoscopic assessment of ulcer status was done until ulcer healing was complete. Evaluations were done after 2, 4, 8, 12, and 16 weeks of therapy.
Ulcer healing was more rapid in patients receiving ranitidine plus triple therapy than in patients receiving ranitidine alone (P less than 0.01). The cumulative percentages of patients with healed ulcers in the group receiving ranitidine plus triple therapy and in the group receiving ranitidine alone were as follows: 37% and 18% after week 2; 74% and 53% after week 4; 84% and 68% after week 8; 96% and 80% after week 12; and 98% and 84% after week 16.
Combined therapy with anti-H. pylori agents and ranitidine was superior to ranitidine alone for duodenal ulcer healing. Our results indicate that H. pylori plays a role in duodenal ulcer disease.
确定幽门螺杆菌感染的抗菌治疗是否能加速十二指肠溃疡的愈合。
单盲、随机、对照试验。
退伍军人事务医院。
105例经内镜证实为十二指肠溃疡的患者。
患者接受雷尼替丁，300毫克/天，或雷尼替丁，300毫克/天，加“三联疗法”（四环素2克/天、甲硝唑750毫克/天，以及每天5或8片次水杨酸铋）。三联疗法仅在溃疡治疗的前2周使用。
进行视频内镜评估溃疡状态，直至溃疡完全愈合。在治疗2周､4周､8周､12周和16周后进行评估。
接受雷尼替丁加三联疗法的患者溃疡愈合比仅接受雷尼替丁的患者更快（P小于0.01）。接受雷尼替丁加三联疗法组和仅接受雷尼替丁组溃疡愈合患者的累积百分比分别如下：第2周后为37%和18%；第4周后为74%和53%；第8周后为84%和68%；第12周后为96%和80%；第16周后为98%和84%。
抗幽门螺杆菌药物与雷尼替丁联合治疗十二指肠溃疡愈合优于单用雷尼替丁。我们的结果表明幽门螺杆菌在十二指肠溃疡疾病中起作用。
