Figueroa G, Acuña R, Troncoso M, Portell D P, Toledo M S, Albornoz V, Vigneaux J
Microbiology Unit, University of Chile, Santiago.
Am J Gastroenterol. 1996 Jul;91(7):1395-9.
We studied prospectively in a single-blind controlled manner the efficacy of 4-wk triple-antibiotic therapy, with amoxicillin (500 mg p.o., t.i.d.), metronidazole (250 mg p.o., t.i.d.), and bismuth subsalicylate tablets (524 mg p.o., q.i.d.), plus omeprazole (20 mg p.o., q.d.) and compared it with omeprazole (id) in the treatment of duodenal ulcer (DU) patients colonized with Helicobacter pylori.
One hundred DU patients were entered prospectively over a 12-month period. Fifty-seven of them received triple therapy plus omeprazole and 43 received omeprazole alone. Clinical, endoscopic, and bacteriological evaluations were performed on admission and at 28 days, 4, 8, and 12 months after treatment.
After 4-wk treatment (day 28), the ulcer healing rate was high, but there was no significant difference between rates in the triple therapy and omeprazole groups (99% vs. 91%). In contrast, the long-term DU recurrence rate after 12-month follow-up was significantly lower (p > 0.01) for triple therapy (3/57, 5%), compared with omeprazole (34/43, 79%). The difference (higher relapse rate for omeprazole-treated patients) was significant (p < 0.001) by the second evaluation, 4 months after treatment. The eradication rate of H. pylori was also significantly higher among DU patients treated with triple therapy (p < 0.001) during all prospective evaluations, grand mean, 82% (range 82-87%), compared with the omeprazole-treated group, in which there were no cases in which H. pylori was eradicated. Follow-up revealed that 2/47 H. pylori-eradicated patients became reinfected after 1 yr, giving a reinfection rate of 4.2 patient/yr.
Four-week triple-antibiotic therapy plus omeprazole constitutes an adequate alternative for treatment of Chilean DU patients.
我们采用单盲对照的前瞻性研究方法，观察阿莫西林（口服500毫克，每日3次）、甲硝唑（口服250毫克，每日3次）和次水杨酸铋片（口服524毫克，每日4次）联合奥美拉唑（口服20毫克，每日1次）进行4周三联抗生素治疗的疗效，并将其与单用奥美拉唑治疗幽门螺杆菌感染的十二指肠溃疡（DU）患者的疗效进行比较。
在12个月的时间里前瞻性纳入100例DU患者。其中57例接受三联疗法加奥美拉唑治疗，43例仅接受奥美拉唑治疗。在入院时以及治疗后28天、4个月、8个月和12个月进行临床、内镜和细菌学评估。
4周治疗（第28天）后，溃疡愈合率较高，但三联疗法组和奥美拉唑组之间的愈合率无显著差异（99%对91%）。相比之下，三联疗法组（3/57，5%）在12个月随访后的长期DU复发率显著低于奥美拉唑组（34/43，79%）（p>0.01）。在治疗后4个月的第二次评估中，差异（奥美拉唑治疗患者的复发率更高）显著（p<0.001）。在所有前瞻性评估中，三联疗法治疗的DU患者中幽门螺杆菌的根除率也显著更高（p<0.001），总体平均值为82%（范围8
