Wang K, Lin H J, Chua R T, Perng C L, Tsay S H, Lee S D
Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 Mar;57(3):184-90.
Omeprazole/amoxicillin regimen has proved elsewhere to be effective in the eradication of Helicobacter pylori (H. pylori). However, in the Chinese, its role in H. pylori is still unclear.
Between November 1993 and June 1994, 112 patients with active, H. pylori positive peptic ulcer were enrolled in this study. Five groups were arranged randomly to have 20 mg omeprazole q.d. for 28 days plus 750 mg amoxicillin b.i.d. for the first 10 days (omep-20-amox group, N = 22), 20 mg omeprazole b.i.d. for 28 days plus 750 mg amoxicillin b.i.d. for the first 10 days (omep-40-amox group, N = 22), 300 mg bismuth subsalicylate q.i.d. for 28 day, and 750 mg amoxicillin b.i.d., 500mg metronidazole t.i.d. for the first 7 days (triple therapy group, N = 25), 20 mg omeprazole q.d. for 28 days (omep-20 group, N = 22), or 150 mg ranitidine b.i.d. or 400 mg cimetidine b.i.d. for 28 days (H2-antagonist group, N = 21).
The eradication rate of H. pylori eight weeks after the entry of study was 38.1% in the omep-20-amox group, 66.7% in the omep-40-amox group, 77.3% in the triple therapy group, 4.7% in the omep-20 group and 0% in the H2 antagonist group (p < 0.05 between the triple therapy and the omep-20-amox, the omep-20, and the H2 antagonist groups). Eleven patients in the triple therapy group suffered from adverse effects (45.8%) (p < 0.05 as compared with other groups). The ulcer healing rates four weeks after the entry of study for the omep-20-amox, the omep-40-amox, the triple therapy, and the omep-20 groups were 80.9%, 80.9%, 68.2%, and 85.7% respectively (p > 0.05). For the H2 antagonist group, the ulcer healing rate eight weeks after the entry of study was 70%.
Both medium-dose omeprazole/amoxicillin and triple therapy can achieve good eradication rates. However, medium-dose omeprazole/amoxicillin had a much lower side effect. Therefore, we recommend medium-dose omeprazole/amoxicillin for the eradication of H. pylori.
奥美拉唑/阿莫西林疗法在其他地方已被证明对根除幽门螺杆菌（H. pylori）有效。然而，在中国，其在幽门螺杆菌治疗中的作用仍不明确。
1993年11月至1994年6月，112例活动性幽门螺杆菌阳性消化性溃疡患者纳入本研究。随机分为五组，分别为：20mg奥美拉唑每日一次，共28天，加750mg阿莫西林每日两次，连用10天（奥美拉唑-20-阿莫西林组，N = 22）；20mg奥美拉唑每日两次，共28天，加750mg阿莫西林每日两次，连用10天（奥美拉唑-40-阿莫西林组，N = 22）；300mg次水杨酸铋每日四次，共28天，加750mg阿莫西林每日两次，500mg甲硝唑每日三次，连用7天（三联疗法组，N = 25）；20mg奥美拉唑每日一次，共28天（奥美拉唑-20组，N = 22）；或150mg雷尼替丁每日两次或400mg西咪替丁每日两次，共28天（H2拮抗剂组，N = 21）。
研究入组8周后，奥美拉唑-20-阿莫西林组幽门螺杆菌根除率为38.1%，奥美拉唑-40-阿莫西林组为66.7%，三联疗法组为77.3%，奥美拉唑-20组为4.7%，H2拮抗剂组为0%（三联疗法组与奥美拉唑-20-阿莫西林组、奥美拉唑-20组和H2拮抗剂组相比，p < 0.05）。三联疗法组有11例患者出现不良反应（45.8%）（与其他组相比，p < 0.05）。研究入组4周后，奥美拉唑-20-阿莫西林组、奥美拉唑-40-阿莫西林组、三联疗法组和奥美拉唑-20组的溃疡愈合率分别为80.9%、80.9%、68.2%和85.7%（p > 0.05）。H2拮抗剂组研究入组8周后的溃疡愈合率为70%。
中剂量奥美拉唑/阿莫西林和三联疗法均能取得较好的根除率。然而，中剂量奥美拉唑/阿莫西林的副作用要低得多。因此，我们推荐使用中剂量奥美拉唑/阿莫西林来根除幽门螺杆菌。
