Abut Evren, Yaşar Bülent, Güveli Hakan, Bölükbaş Cengiz, Bölükbaş Filiz Füsun, Dalay Ali Remzi, Kurdaş Oya Ovünç
Department of Gastroenterology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Scand J Gastroenterol. 2010 Jun;45(6):677-83. doi: 10.3109/00365521003702726.
Because Helicobacter pylori creates a well-sheltered microenvironment within the gastric mucus layer, it has been speculated that the disruption of this space by a mucolytic agent may enhance the eradication rate. The aim of the present study was to investigate the effect of erdosteine, a strong mucolytic agent, on the effectiveness of PPI-based, first-line triple therapy in the eradication of H. pylori.
Initially, 196 patients were enrolled to the study. Of these, 79 H. pylori-positive patients were randomized to the erdosteine group (triple therapy consisting of pantoprazole, amoxicillin and clarithromycin plus erdosteine; n = 40) or the placebo group (triple therapy plus placebo; n = 39) for 14 days. Endoscopic biopsies and (13)C-urea breath tests were performed at entry and at 4-6 weeks after the completion of the treatment. Additionally, rapid urease tests were performed at entry.
The eradication of H. pylori was achieved in 30 (75%) of the 40 patients in the erdosteine group and in 20 (51.3%) of the 39 patients in the placebo group, according to the ITT analysis (p = 0.028). When the PP analysis was performed as well, H. pylori eradication was achieved in 30 (78.9%) of the 38 patients in the erdosteine group and in 20 (52.6%) of the 38 patients in the placebo group (p = 0.016).
Erdosteine is an efficient adjuvant therapy that could be used in conjunction with first-line triple therapy in the treatment of H. pylori.
由于幽门螺杆菌在胃黏液层内营造了一个良好的庇护微环境，因此有人推测，黏液溶解剂破坏这个空间可能会提高根除率。本研究的目的是探讨强力黏液溶解剂厄多司坦对基于质子泵抑制剂的一线三联疗法根除幽门螺杆菌有效性的影响。
最初，196名患者纳入本研究。其中，79名幽门螺杆菌阳性患者被随机分为厄多司坦组（泮托拉唑、阿莫西林和克拉霉素三联疗法加厄多司坦；n = 40）或安慰剂组（三联疗法加安慰剂；n = 39），治疗14天。在入组时以及治疗完成后4 - 6周进行内镜活检和碳-13尿素呼气试验。此外，在入组时进行快速尿素酶试验。
根据意向性分析，厄多司坦组40例患者中有30例（75%）实现幽门螺杆菌根除，安慰剂组39例患者中有20例（51.3%）实现根除（p = 0.028）。进行符合方案分析时，厄多司坦组38例患者中有30例（78.9%）实现幽门螺杆菌根除，安慰剂组38例患者中有20例（52.6%）实现根除（p = 0.016）。
厄多司坦是一种有效的辅助治疗药物，可与一线三联疗法联合用于幽门螺杆菌的治疗。
