Börsch G
Medizinische Klinik der Ruhr-Universität am St.-Josef-Hospital Bochum.
Leber Magen Darm. 1988 Feb;18(1):38-45.
A simple and efficient therapy eradicating C. pylori with high reliability from gastroduodenal mucosae is presently unknown. In regard to such a "puristic" approach, antibiotics given as monotherapy are presently as ineffective as bismuth salts, which may temporarily reduce the bacterial density, but yield a low complete bacterial eradication rate of not more than 10% to 30% of all patients. Pilot studies are being performed in many centers to identify more efficacious drugs or combinations. Alternative modalities, such as manipulation of mucus, active vaccination, or clearing of bacterial sources in the environment, presently represent nothing but hypothetical models. Bismuth salts might play an important future role in a more "pragmatic" approach, which investigates any potential clinical benefit derived from a mere suppression of bacterial growth, possibly resulting in a temporary restoration of the mucosal integrity. However, this approach will probably fail to modify the long-term natural history of C. pylori-associated chronic gastritis and its sequelae.
目前尚不清楚一种能从胃十二指肠黏膜高效可靠地根除幽门螺杆菌的简单有效疗法。就这种“纯粹主义”方法而言，目前单药使用抗生素与铋盐一样无效，铋盐虽可暂时降低细菌密度，但在所有患者中实现的细菌完全根除率较低，不超过10%至30%。许多中心正在进行初步研究以确定更有效的药物或联合用药方案。替代方法，如调节黏液、主动免疫或清除环境中的细菌来源，目前仅仅是假设模型。铋盐可能在更“实用主义”的方法中发挥重要的未来作用，该方法研究单纯抑制细菌生长可能带来的任何潜在临床益处，这可能会使黏膜完整性暂时恢复。然而，这种方法可能无法改变幽门螺杆菌相关慢性胃炎及其后遗症的长期自然病程。
