Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2013 Jul;29(7):379-84. doi: 10.1016/j.kjms.2012.11.006. Epub 2013 Jan 12.
Different types of proton pump inhibitor (PPI)-based triple therapies could result in different Helicobacter pylori eradication rates. This study aimed to compare the efficacy and safety of rabeprazole- and lansoprazole-based triple therapies in primary treatment of H. pylori infection. From September 2005 to July 2008, 426 H. pylori-infected patients were randomly assigned to receive a 7-day eradication therapy with either rabeprazole 20mgbid (RAC group, n=222) or lansoprazole 30mgbid (LAC group, n=228) in combination with amoxicillin 1gbid and clarithromycin 500mgbid. The patients received follow-up esophagogastroduodenoscopy (EGD) and/or (13)C-urea breath test 12-16 weeks later to define H. pylori status. Their personal and medical history, compliance and side effects were obtained by using a standardized questionnaire. Intention-to-treat analysis revealed that the eradication rate was 87.84% in the RAC group and 85.96% in the LAC group (p=0.56). All patients returned for assessment of compliance (100% in the LAC group vs. 99.50% in the RAC group; p=0.32) and adverse events (7.20% in the RAC group vs. 5.70% in the LAC group, p=0.51). Univariate analysis suggested that patients with nonsteroid anti-inflammatory agent (NSAID) use had lower eradication rates than those without (76.71% vs. 88.74%; p=0.006). Our results showed that efficacy and safety were similar in rabeprazole- and lansoprazole-based primary therapies. The influence of NSAID usage on H. pylori eradication needs to be further investigated.
不同类型的质子泵抑制剂（PPI）三联疗法可能导致不同的幽门螺杆菌根除率。本研究旨在比较雷贝拉唑和兰索拉唑三联疗法在幽门螺杆菌感染初次治疗中的疗效和安全性。 从 2005 年 9 月至 2008 年 7 月，426 例幽门螺杆菌感染患者被随机分为雷贝拉唑 20mgbid（RAC 组，n=222）或兰索拉唑 30mgbid（LAC 组，n=228）联合阿莫西林 1gbid 和克拉霉素 500mgbid 的 7 天根除治疗组。患者在 12-16 周后接受随访食管胃十二指肠镜检查（EGD）和/或（13）C-尿素呼气试验以确定幽门螺杆菌状态。通过使用标准化问卷获得患者的个人和医疗史、依从性和副作用。意向治疗分析显示 RAC 组的根除率为 87.84%，LAC 组为 85.96%（p=0.56）。所有患者均返回评估依从性（LAC 组为 100%，RAC 组为 99.50%；p=0.32）和不良事件（RAC 组为 7.20%，LAC 组为 5.70%；p=0.51）。单因素分析表明，使用非甾体抗炎药（NSAID）的患者根除率低于未使用 NSAID 的患者（76.71%比 88.74%；p=0.006）。我们的结果表明，雷贝拉唑和兰索拉唑为基础的初次治疗的疗效和安全性相似。NSAID 使用对幽门螺杆菌根除的影响需要进一步研究。
