Miederer S
Medizinische Klinik, Ev. Johannes-Krankenhaus, Bielefeld.
Fortschr Med. 1996 Nov 30;114(33):460-2.
Peptic ulcer disease induced by infection with Helicobacter pylori can be cured by eradicating the organism. In the meantime, such eradication therapy has moved beyond the experimental stage and can now be applied in the doctor's office, effectively, safely and inexpensively. A seven to twelve day course of treatment comprising a gastric acid inhibitor (20 mg omeprazole twice daily is no more effective than 300 mg ranitidine daily), 500 mg metronidazole twice daily, and 1 g amoxicillin twice daily results in an eradication rate of about 90%. That is, repeat treatment is needed in only one in ten patients. The cost of eradication therapy, however, varies considerably: the treatment recommended by the "initiative in support of the new form of ulcer treatment" costs DM 512.27, while equally effective treatment using generics costs only about one-fifth of this amount. In this way, a troublesome illness that for thousands of years has received only symptomatic treatment and whose sequelae cause high costs can now be treated causally with a high success rate and also a favourable cost-benefit ratio.
幽门螺杆菌感染引起的消化性溃疡病可通过根除该病菌得到治愈。与此同时,这种根除疗法已超越实验阶段,现在可在医生诊所有效、安全且廉价地应用。一个为期七至十二天的疗程,包括一种胃酸抑制剂(每日两次服用20毫克奥美拉唑并不比每日服用300毫克雷尼替丁更有效)、每日两次服用500毫克甲硝唑以及每日两次服用1克阿莫西林,根除率约为90%。也就是说,每十名患者中仅一名需要重复治疗。然而,根除疗法的费用差异很大:“支持新型溃疡治疗倡议”推荐的治疗费用为512.27德国马克,而使用非专利药的同等有效治疗费用仅约为此金额的五分之一。这样一来,一种数千年来仅接受对症治疗且其后遗症造成高昂费用的棘手疾病,现在可以通过病因治疗获得高成功率,并且成本效益比也很可观。