Vautier G, Scott B B
Department of Medicine, County Hospital, Lincoln, UK.
Aliment Pharmacol Ther. 1997 Feb;11(1):107-8. doi: 10.1046/j.1365-2036.1997.87259000.x.
The addition of omeprazole to 1 week of standard triple therapy (tripotassium dicitrato bismuthate, tetracycline and metronidazole) has given a 98% eradication rate in 54 patients at 4-6 weeks in a research setting. We report the result of a similar 1-week regimen in 52 patients in routine clinical practice assessed at a mean of 8 months.
Fifty-two patients with peptic ulcer disease and antral biopsies containing Helicobacter pylori sensitive to metronidazole were given a 7-day course of treatment: omeprazole 20 mg b.d., tetracycline 500 mg q.d.s. and tripotassium dictitrato bismuthate chelate tablets 120 mg q.d.s., with metronidazole 400 mg five times daily for the last 3 days only. Completeness of eradication was assessed by a 13C-urea breath test at 4-26 months (mean 8 months).
Forty-eight patients (92%) had a negative breath test. Three patients vomited on the last day of the course, otherwise the treatment was well tolerated with the expected minor side-effects of tongue discoloration, nausea and unpleasant taste.
The efficacy of a modified 1-week standard triple therapy with omeprazole is confirmed and shown to be almost as effective in routine clinical practice as a similar regimen in a research setting.
在一项研究中,在标准三联疗法(枸橼酸铋钾、四环素和甲硝唑)基础上加用奥美拉唑治疗1周,54例患者在4至6周时幽门螺杆菌根除率达98%。我们报告了在常规临床实践中对52例患者采用类似的1周治疗方案的结果,平均在8个月时进行评估。
52例患有消化性溃疡疾病且胃窦活检显示幽门螺杆菌对甲硝唑敏感的患者接受为期7天的治疗:奥美拉唑20毫克,每日2次;四环素500毫克,每日4次;枸橼酸铋钾螯合片120毫克,每日4次,仅在最后3天加用甲硝唑400毫克,每日5次。在4至26个月(平均8个月)时通过13C尿素呼气试验评估根除的完整性。
48例患者(92%)呼气试验结果为阴性。3例患者在疗程最后一天出现呕吐,除此之外,治疗耐受性良好,有预期的轻微副作用,如舌苔变色、恶心和口味不佳。
含奥美拉唑的改良1周标准三联疗法的疗效得到证实,且在常规临床实践中显示出与研究环境中类似方案几乎同样有效。