Spadaccini A, De Fanis C, Sciampa G, Masciulli V, Pantaleone U, Di Virgilio M, Magnarini C, Pizzicannella G
Service of Gastroenterology and Digestive Endoscopy, General Hospital, Vasto (Ch), Italy.
Aliment Pharmacol Ther. 1996 Oct;10(5):829-31. doi: 10.1046/j.1365-2036.1996.54196000.x.
To compare the results of two short triple-therapy regimens, different only in the antisecretory drugs used, in patients with active duodenal ulcer and Helicobacter pylori infection.
All patients received a combination of clarithromycin 250 mg b.d. and tinidazole 500 mg b.d. for 1 week, in addition to an antisecretory drug: omeprazole 20 mg (50 patients) or ranitidine 300 mg (50 patients) twice daily for 1 week, followed by a single daily dose for a further 3 weeks. Upper gastrointestinal endoscopy, with rapid urease test and histological examination of antral and corpus biopsies, was performed prior to the treatment and at least 2 months after the discontinuation of the antisecretory therapy.
Duodenal ulcer healing was documented in all patients at the endoscopic examination after therapy. H. pylori eradication was achieved in 46 of 50 patients (92%, 95% CI = 85-99%) in the omeprazole group and in 43 of 50 patients (86%, 95% CI = 76-96%) in the ranitidine group: the difference is not significant.
Omeprazole or ranitidine, in combination with clarithromycin and tinidazole, are equally effective in the eradication of H. pylori infection and healing of duodenal ulcers.
比较两种仅在使用的抗分泌药物上有所不同的短程三联疗法方案，用于治疗活动性十二指肠溃疡并伴有幽门螺杆菌感染的患者。
所有患者除服用抗分泌药物外，均接受克拉霉素250毫克，每日两次，替硝唑500毫克，每日两次，共1周：奥美拉唑20毫克（50例患者）或雷尼替丁300毫克（50例患者），每日两次，共1周，之后单剂量服用再持续3周。在治疗前以及停止抗分泌治疗后至少2个月进行上消化道内镜检查，同时进行快速尿素酶试验以及胃窦和胃体活检的组织学检查。
治疗后所有患者的内镜检查均证实十二指肠溃疡愈合。奥美拉唑组50例患者中有46例（92%，95%可信区间=85-99%）实现幽门螺杆菌根除，雷尼替丁组50例患者中有43例（86%，95%可信区间=76-96%）实现根除：差异无统计学意义。
奥美拉唑或雷尼替丁联合克拉霉素和替硝唑在根除幽门螺杆菌感染以及十二指肠溃疡愈合方面同样有效。
