Dettmer A
Facharztpraxis für Innere Medizin/Gastroenterologie, München.
Arzneimittelforschung. 1995 May;45(5):604-7.
The results of many clinical studies have indicated that the eradication of Helicobacter pylori leads to a reduction in ulcer relapse.
The aim of this double-blind, randomized, multicenter comparative study in 196 patients with H. pylori positive duodenal ulcer was to examine the efficacy and safety of two eradication therapies with ranitidine. The patients were treated daily with 4 x 150 mg ranitidine (CAS 66357-35-5, Sostril, Zantic) combined with 4 x 500 mg amoxicillin (CAS 26787-78-0, Amoxypen) (group 1) or 4 x 300 mg ranitidine (Sostril 300, Zantic 300) combined with 4 x 500 mg amoxicillin (group 2) for two weeks and during next two weeks with 300 mg ranitidine only.
The final endoscopic investigation 6 weeks yielded healing rates of 90% (group 1) or 96% (group 2). Histopathological examination/urease test of biopsy showed successful eradication of H. pylori in 65%/60% (group 1) or 63%/69% (group 2) of patients. The treatment therapies were generally well or very well tolerated. Adverse events required drug withdrawal only in 3 patients (1.5%).
A combination with ranitidine and amoxicillin is an effective and well tolerated therapy in H. pylori infected duodenal ulcer patients. The eradication rate does not seem to be further improved by a ranitidine dose higher than 600 mg daily.
许多临床研究结果表明,根除幽门螺杆菌可降低溃疡复发率。
本双盲、随机、多中心比较研究针对196例幽门螺杆菌阳性十二指肠溃疡患者,旨在检验两种雷尼替丁根除疗法的疗效和安全性。患者每日接受4次150毫克雷尼替丁(CAS 66357-35-5,索司特里尔,赞替克)联合4次500毫克阿莫西林(CAS 26787-78-0,阿莫西林)治疗(第1组),或4次300毫克雷尼替丁(索司特里尔300,赞替克300)联合4次500毫克阿莫西林治疗(第2组),为期两周,接下来两周仅接受300毫克雷尼替丁治疗。
6周后的最终内镜检查显示,第1组愈合率为90%,第2组为96%。活检的组织病理学检查/尿素酶试验显示,第1组65%/60%的患者、第2组63%/69%的患者幽门螺杆菌根除成功。治疗方案总体耐受性良好或非常好。仅3例患者(1.5%)因不良事件需要停药。
雷尼替丁与阿莫西林联合使用,对于幽门螺杆菌感染的十二指肠溃疡患者是一种有效且耐受性良好的治疗方法。每日雷尼替丁剂量高于600毫克似乎并不能进一步提高根除率。