Blum A L, Kreiss C, Armstrong D
Hôpital Cantonal Universitaire Vaudois, Département de Médecine Interne, Lausanne, Switzerland.
Leber Magen Darm. 1995 May;25(3):112-6, 119-20.
At the present, Helicobacter-associated gastritis is not considered to be an important cause of dyspeptic symptoms. Therefore, patients with dyspeptic symptoms and proven Helicobacter-gastritis are diagnosed as having functional dyspepsia, provided that Helicobacter-associated lesions like ulcers or malignancies are absent. It is controversial whether or not to treat a patient with functional dyspepsia with Helicobacter gastritis. Conclusive controlled clinical trials are lacking. If it is assumed in a given patient, that Helicobacter could be responsible for the complaints (an assumption which can never be proven and only suspected when the patient remains asymptomatic during longterm follow-up after cure of the infection) and if the patient has not responded to a standard treatment (antisecretory or prokinetic agents), we recommend Helicobacter therapy. Presently, in spring 1995, the following treatment is, in our view, the best choice during seven (to ten) days: The patient takes 20 mg omeprazol in the morning, 250 mg clarithromycin in the morning and in the evening and 500 mg metronidazole in the morning and in the evening.
目前,幽门螺杆菌相关性胃炎不被认为是消化不良症状的重要病因。因此,有消化不良症状且已证实患有幽门螺杆菌胃炎的患者,若不存在幽门螺杆菌相关病变如溃疡或恶性肿瘤,则被诊断为功能性消化不良。对于患有幽门螺杆菌胃炎的功能性消化不良患者是否进行治疗存在争议。缺乏确凿的对照临床试验。如果在某一特定患者中假设幽门螺杆菌可能是导致症状的原因(这种假设永远无法得到证实,只有在感染治愈后的长期随访中患者仍无症状时才会被怀疑),并且该患者对标准治疗(抗分泌或促动力药物)无反应,我们建议进行幽门螺杆菌治疗。目前,在1995年春季,我们认为以下治疗方案在七(至十)天内是最佳选择:患者早晨服用20毫克奥美拉唑,早晚各服用250毫克克拉霉素,早晚各服用500毫克甲硝唑。