McCarthy C J, Collins R, Beattie S, Hamilton H, O'Morain C
Department of Gastroenterology, Meath/Adelaide Hospitals, Trinity College, Dublin, Ireland.
Aliment Pharmacol Ther. 1993 Aug;7(4):463-6. doi: 10.1111/j.1365-2036.1993.tb00121.x.
Omeprazole heals most duodenal ulcers after 4 weeks of treatment but relapse is common. Eradication of Helicobacter pylori is associated with reduced rate of ulcer relapse. This study investigates the effect of omeprazole with antibiotics in H. pylori-associated duodenal ulceration. Forty-three patients with endoscopically proven duodenal ulcer and H. pylori entered this study. Treatment consisted of 20 mg omeprazole daily (four weeks) and seven days (first week) treatment with 400 mg metronidazole t.d.s. and 500 mg tetracycline t.d.s. Four weeks after completing the treatment, 81% (35/43) had a healed duodenal ulcer, and 58% (25/43) had H. pylori eradication. In those who healed, at one year 21 remained H. pylori-negative, 12 had persistent H. pylori infection and 2 had re-infection. The ulcer relapse rate at one year was 26%: of the 9 who relapsed, 6 had persistent infection, 2 were re-infected, and only 1 was H. pylori-negative. This combination therapy of antibiotics with omeprazole successfully eradicates Helicobacter pylori and has a lower ulcer relapse than omeprazole alone.
奥美拉唑治疗4周后可治愈大多数十二指肠溃疡，但复发很常见。根除幽门螺杆菌可降低溃疡复发率。本研究调查了奥美拉唑联合抗生素治疗幽门螺杆菌相关性十二指肠溃疡的效果。43例经内镜证实患有十二指肠溃疡且感染幽门螺杆菌的患者进入本研究。治疗方案为每日服用20毫克奥美拉唑（共四周），并在第一周同时服用甲硝唑400毫克，每日三次，四环素500毫克，每日三次，共七天。治疗结束四周后，81%（35/43）的患者十二指肠溃疡愈合，58%（25/43）的患者幽门螺杆菌被根除。在溃疡愈合的患者中，一年后21人幽门螺杆菌呈阴性，12人持续感染幽门螺杆菌，2人再次感染。一年时溃疡复发率为26%：在9例复发患者中，6例持续感染，2例再次感染，只有1例幽门螺杆菌呈阴性。抗生素与奥美拉唑的这种联合疗法成功根除了幽门螺杆菌，且溃疡复发率低于单用奥美拉唑。
