Shimoyama T, Munakata A, Mizuki I, Akagi T, Fukuda S, Ohkawa K, Yoshida Y, Aisawa T, Sakata Y, Fukushi M
First Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan.
J Clin Gastroenterol. 1995;20 Suppl 2:S125-7. doi: 10.1097/00004836-199506002-00034.
This study attempted to determine the efficacy of lansoprazole plus clarithromycin therapy in the eradication of Helicobacter pylori in gastric ulcer patients. The influence of H. pylori eradication on healing and relapse of ulcers was also studied. Thirty-nine patients received either lansoprazole 30 mg daily for 8 weeks (group 1) or clarithromycin 200 mg twice daily for 2 weeks and lansoprazole 30 mg daily for 8 weeks (group 2). Before treatment, H. pylori status was evaluated by a rapid urease test and histologic examination. H. pylori clearance and eradication were evaluated by a rapid urease test, polymerase chain reaction, and a [13C]urea breath test. Clearance of H. pylori was 0% in group 1 and was 33% in group 2. Eradication of H. pylori was 0% in group 1 and 21% in group 2. Although all five ulcers were healed in patients with H. pylori eradication, ulcers were not healed in the five patients without eradication. Relapse of ulcer was observed in three patients in whom eradication had failed. In this study, for H. pylori-positive gastric ulcer patients, better results were obtained when lansoprazole plus clarithromycin therapy was used, and H. pylori eradication was achieved.
本研究试图确定兰索拉唑联合克拉霉素疗法根除胃溃疡患者幽门螺杆菌的疗效。还研究了根除幽门螺杆菌对溃疡愈合和复发的影响。39例患者接受以下治疗：每日30毫克兰索拉唑，疗程8周（第1组）；或每日2次、每次200毫克克拉霉素，疗程2周，随后每日30毫克兰索拉唑，疗程8周（第2组）。治疗前，通过快速尿素酶试验和组织学检查评估幽门螺杆菌状态。通过快速尿素酶试验、聚合酶链反应和[13C]尿素呼气试验评估幽门螺杆菌的清除和根除情况。第1组幽门螺杆菌清除率为0%，第2组为33%。第1组幽门螺杆菌根除率为0%，第2组为21%。虽然幽门螺杆菌根除的患者中所有5处溃疡均愈合，但未根除的5例患者溃疡未愈合。在根除失败的3例患者中观察到溃疡复发。在本研究中，对于幽门螺杆菌阳性的胃溃疡患者，使用兰索拉唑联合克拉霉素疗法可取得更好的效果，并实现幽门螺杆菌的根除。
