Kodama R, Fujioka T, Fujiyama K, Kawasaki H, Kubota T, Nasu M
Second Department of Internal Medicine, Oita Medical University, Japan.
Eur J Gastroenterol Hepatol. 1994 Dec;6 Suppl 1:S125-8.
To clarify the efficacy of combination therapy with clarithromycin and sofalcone for eradication of Helicobacter pylori.
We studied 42 patients with H. pylori-positive gastroduodenal diseases, who were divided into two groups according to treatment period. Group 1 comprised 27 patients (seven with gastric ulcers, 14 with duodenal ulcers and six with gastritis) treated with a combination of clarithromycin (200 mg, three times a day) + sofalcone (100 mg, three times a day) for 3 weeks. Group 2 comprised 15 patients with chronic active gastritis treated with the same doses of clarithromycin + sofalcone but for only 2 weeks (group 2). The H. pylori status of all patients was assessed by culture, rapid urease test and histological examination at the end of treatment and 4 weeks after the end of treatment. The gastritis score, the index of intracellular periodic acid-Schiff-positive substance in the antral mucosa and the ammonia concentration in gastric secretions were also estimated before and after treatment.
In group 1, with over half the patients excluded from the follow-up, H. pylori was eradicated in nine out of 13 patients (69.2%) compared with six out of the complete group of 15 (40.0%) patients in group 2, without serious side effects. In these patients, significant improvements were seen in the gastritis score (P < 0.025), the index of periodic acid-Schiff-positive substances in the antral mucosa (P < 0.025) and the ammonia concentration in gastric secretions (P < 0.02) after treatment.
These results suggest that modification of the treatment regimen is needed, with higher doses of clarithromycin and combination therapy with proton-pump inhibition.
阐明克拉霉素与索法酮联合治疗根除幽门螺杆菌的疗效。
我们研究了42例幽门螺杆菌阳性的胃十二指肠疾病患者，根据治疗周期将其分为两组。第1组包括27例患者（7例胃溃疡、14例十二指肠溃疡和6例胃炎），接受克拉霉素（200毫克，每日3次）+索法酮（100毫克，每日3次）联合治疗3周。第2组包括15例慢性活动性胃炎患者，接受相同剂量的克拉霉素+索法酮，但仅治疗2周（第2组）。在治疗结束时及治疗结束后4周，通过培养、快速尿素酶试验和组织学检查评估所有患者的幽门螺杆菌状况。还在治疗前后评估了胃炎评分、胃窦黏膜中胞内过碘酸希夫阳性物质指数和胃分泌物中的氨浓度。
在第1组中，超过一半的患者未纳入随访，13例患者中有9例（69.2%）幽门螺杆菌被根除，而第2组15例完整组患者中有6例（40.0%），且无严重副作用。在这些患者中，治疗后胃炎评分（P<0.025）、胃窦黏膜中过碘酸希夫阳性物质指数（P<0.025）和胃分泌物中氨浓度（P<0.02）有显著改善。
这些结果表明需要调整治疗方案，采用更高剂量的克拉霉素并联合质子泵抑制治疗。
