Sugiyama T, Hisano K, Ochiai T, Fujita N, Kobayashi T, Yabana T, Kurokawa I, Yachi A
Department of Laboratory Diagnosis, Sapporo Medical University School of Medicine, Japan.
J Clin Gastroenterol. 1995;20 Suppl 2:S104-6. doi: 10.1097/00004836-199506002-00028.
Helicobacter pylori is a major cause of gastritis and an important factor in duodenal ulcer relapse. Eradication of H. pylori has usually been achieved by triple therapy, a combination of bismuth salts and two antibiotics. The disadvantage of these regimens is the large number of tablets and the high incidence of side effects. A new H+,K(+)-ATPase inhibitor, lansoprazole (LPZ), has a strong acid inhibitory effect and an anti-H. pylori effect in vitro. These dual effects have an advantage for the eradication of H. pylori by LPZ alone or by a combination of LPZ and antibiotics. In this study, we investigated an anti-H. pylori effect of LPZ alone and LPZ plus low-dose amoxicillin and the relation between the status of H. pylori colonization and the endoscopic healing stage. LPZ monotherapy suppressed H. pylori but did not eradicate it. LPZ plus low-dose amoxicillin dual therapy eradicated H. pylori in 45.5% of patients with gastric ulcer disease. However, this rate is not satisfactory for eradication therapy. The optimal dosage and duration of treatment need to be specified. A high rate of healing to the endoscopic S2 stage was achieved by eradication of H. pylori and the recurrence of gastric ulcer was suppressed in patients in whom H. pylori was eradicated. The eradication of H. pylori may change the natural course of gastric ulcer disease as it does in duodenal ulcer disease.
幽门螺杆菌是胃炎的主要病因以及十二指肠溃疡复发的重要因素。根除幽门螺杆菌通常采用三联疗法，即铋盐与两种抗生素联合使用。这些治疗方案的缺点是片剂数量多且副作用发生率高。一种新型的H⁺，K⁺-ATP酶抑制剂兰索拉唑（LPZ）具有很强的抑酸作用，并且在体外具有抗幽门螺杆菌的作用。这些双重作用对于单独使用LPZ或LPZ与抗生素联合使用来根除幽门螺杆菌具有优势。在本研究中，我们调查了单独使用LPZ以及LPZ加小剂量阿莫西林的抗幽门螺杆菌作用，以及幽门螺杆菌定植状态与内镜愈合阶段之间的关系。LPZ单一疗法可抑制幽门螺杆菌，但不能将其根除。LPZ加小剂量阿莫西林的联合疗法使45.5%的胃溃疡病患者根除了幽门螺杆菌。然而，这个根除率对于根除治疗来说并不令人满意。需要确定最佳的治疗剂量和疗程。通过根除幽门螺杆菌可使内镜愈合达到S2期的比例很高，并且根除幽门螺杆菌的患者胃溃疡复发得到了抑制。根除幽门螺杆菌可能会像在十二指肠溃疡病中一样改变胃溃疡病的自然病程。
