Dobrilla G, Piazzi L, Amplatz S
División de Gastroenterología, Hospital General Regional, Bolzano, Italia.
An Med Interna. 1993 Feb;10(2):91-7.
The authors examine the relationship between Helicobacter pylori and gastric ulcer therapy, analyzing both the data suggesting that eradication of the organism renders the gastric mucosa less susceptible to development of gastric ulcer and the substantial body of evidence to the contrary. They review the results reported in clinical trials with colloidal bismuth subcitrate, antimicrobial agents (furazolidone), and combinations of antiulcer and antimicrobial agents (H2-antagonist + cefixime, H2-antagonist + metronidazole). Also analyzed is the relationship between Helicobacter pylori eradication and ulcer recurrence; only one study is available on this aspect, and the limited evidence it provides in favour of a prophylactic effect of eradication therapy is not entirely convincing. The authors conclude that there is no reasonable case for the dogmatic assumption that eradication of Helicobacter pylori facilitates either acute healing or long-term prophylaxis of gastric ulcer, though certain subgroups of gastric ulcer patients may benefit from eradication therapy.
作者研究了幽门螺杆菌与胃溃疡治疗之间的关系，分析了表明根除该菌可使胃黏膜不易发生胃溃疡的数据，以及大量相反的证据。他们回顾了关于枸橼酸铋胶体、抗菌药物（呋喃唑酮）以及抗溃疡与抗菌药物联合使用（H2拮抗剂+头孢克肟、H2拮抗剂+甲硝唑）的临床试验报告结果。还分析了幽门螺杆菌根除与溃疡复发之间的关系；关于这方面仅有一项研究，其提供的支持根除治疗具有预防作用的有限证据并不完全令人信服。作者得出结论，虽然某些胃溃疡患者亚组可能从根除治疗中获益，但对于根除幽门螺杆菌有助于胃溃疡的急性愈合或长期预防这一教条式假设，并无合理依据。
