Thijs J C, Van Zwet A A, Oey H B
Dept. of Internal Medicine, Bethesda Hospital, Hoogeveen, The Netherlands.
Scand J Gastroenterol. 1993 Nov;28(11):934-8. doi: 10.3109/00365529309098287.
One hundred consecutive patients with Helicobacter pylori infection, as proven by culture, were treated with 120 mg colloidal bismuth subcitrate (CBS) four times daily, 250 mg tetracycline four times daily, and 250 mg metronidazole four times daily during 15 days. The patients were amply instructed in how to take the medicine and strongly urged to complete the prescribed course. In 66 of the 100 patients pretreatment metronidazole susceptibility was determined. Endoscopy was performed 3 months after cessation of treatment to check for H. pylori eradication by culture, urease testing, and histology. Side effects of the treatment were registered and classified into five groups on the basis of severity. Eradication was achieved in 93 of 100 patients (93%), in 61 of 62 patients with a metronidazole-sensitive strain (98.4%), and in 2 of 4 patients with a metronidazole-resistant strain (50%). Eighty-two per cent of the patients experienced no or just minor side effects; 15% had moderate side effects, and just 3% had severe side effects. Non-ulcer dyspepsia patients reported significantly more side effects than patients with peptic ulcer disease. With proper patient instruction, this treatment regimen is well tolerated and very effective for the eradication of metronidazole-sensitive H. pylori strains.
连续100例经培养证实为幽门螺杆菌感染的患者，接受为期15天的治疗，每日4次服用120毫克枸橼酸铋钾（CBS）、每日4次服用250毫克四环素、每日4次服用250毫克甲硝唑。对患者进行了充分的用药指导，并强烈敦促其完成规定疗程。在100例患者中的66例中，测定了治疗前甲硝唑的敏感性。治疗结束3个月后进行内镜检查，通过培养、尿素酶检测和组织学检查来检查幽门螺杆菌是否根除。记录治疗的副作用，并根据严重程度分为五组。100例患者中有93例（93%）实现了根除，62例甲硝唑敏感菌株患者中有61例（98.4%）实现了根除，4例甲硝唑耐药菌株患者中有2例（50%）实现了根除。82%的患者未出现或仅出现轻微副作用；15%的患者有中度副作用，仅有3%的患者有严重副作用。非溃疡性消化不良患者报告的副作用明显多于消化性溃疡疾病患者。通过对患者进行适当的指导，这种治疗方案耐受性良好，对根除甲硝唑敏感的幽门螺杆菌菌株非常有效。
