Emami Mohammad Hasan, Arjmandpour Akbar, Daghaghzadeh Hamed, Rahimi Hojatollah, Toghiani Ali, Adibi Peyman
Department of Internal Medicine, School of Medicine, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Young Researchers and Elite Club, Najafabad Branch, Islamic Azad University, Najafabad, Iran.
Adv Biomed Res. 2015 Jul 27;4:143. doi: 10.4103/2277-9175.161551. eCollection 2015.
Helicobacter pylori colonizes not only on the surface of mucous membrane, but also beneath the surface mucous gel layer (SMGL). As diclofenac Na decreases the secretion of SMGL, in this study we examined this drug as an adjuvant therapy to a quadruple therapy for H. Pylori eradication.
One hundred and seventy-two patients were randomly assigned to three groups. Fifty four patients received quadruple therapy, that is, azithromycine 250 mg, amoxicillin 500 mg, bismuth subcitrate 240 mg, and omeprazole 20 mg bid for 1 week (group A) and 65 patients received the same dosage of those agents plus diclofenac Na tab, 100 mg daily for 1 week (group B). Sixty two patients received the quadruple therapy for 2 weeks (group C). Eradication of the infection was assessed 4-6 weeks after completion of treatment by stool antigen assay for H. pylori.
While the rate of H. pylori eradication in the groups A and B was 66.7% and 82.1%, respectively (P = 0.062), the rate of H. pylori eradication in groups B and C were 82.1% and 82.3% respectively (P = 0.987).
It seems that diclofenac Na can shorten anti-H. pylori regimens for 1 week. More investigations are needed for more clarification of the efficacy of NSAIDs for successful eradication of H. pylori. (IRCT code: IRCT201204059256N2).
幽门螺杆菌不仅定殖于黏膜表面,还定殖于表面黏液凝胶层(SMGL)下方。由于双氯芬酸钠会减少SMGL的分泌,在本研究中,我们将此药物作为根除幽门螺杆菌的四联疗法的辅助治疗进行了检测。
172例患者被随机分为三组。54例患者接受四联疗法,即阿奇霉素250毫克、阿莫西林500毫克、枸橼酸铋240毫克和奥美拉唑20毫克,每日两次,共1周(A组);65例患者接受相同剂量的这些药物加双氯芬酸钠片,每日100毫克,共1周(B组)。62例患者接受四联疗法2周(C组)。治疗结束后4至6周,通过检测粪便幽门螺杆菌抗原评估感染的根除情况。
A组和B组的幽门螺杆菌根除率分别为66.7%和82.1%(P = 0.062),B组和C组的幽门螺杆菌根除率分别为82.1%和82.3%(P = 0.987)。
双氯芬酸钠似乎可以将抗幽门螺杆菌治疗方案缩短1周。需要更多研究来进一步明确非甾体抗炎药在成功根除幽门螺杆菌方面的疗效。(伊朗临床试验注册中心代码:IRCT201204059256N2)