Tan W C, Hogan J, Purkayastha S K, Lombard M, Krasner N
Department of Gastroenterology, Fazakerley Hospital, Liverpool, UK.
Int J Clin Pract. 1997 Jun;51(4):214-6.
Helicobacter pylori (Hp) eradication in peptic ulcer disease is associated with a greatly reduced recurrence rate. The optimal drug regimen for HP eradication remains uncertain. It is also unclear if eradication of Hp in duodenitis and antral gastritis improves symptoms. The aims of this study were to compare the efficacy of three drug regimens in the eradication of Hp and to assess if Hp eradication improved symptoms in patients with duodenitis and antral gastritis. Patients (n = 79) found to have duodenal ulcer, duodenitis and/or antral gastritis with a positive urease test (CLO) at endoscopy were allocated to one of the three regimens: A. omeprazole 20 mg b.d. and clarithromycin 500 mg t.d.s. for two weeks (n = 27), B. De-Nol 240 mg b.d. for four weeks, metronidazole 400 mg t.d.s. and amoxicillin 500 mg t.d.s. for one week (n = 26), and C. omeprazole 20 mg b.d. and amoxicillin 500 mg t.d.s. for two weeks (n = 26). In conclusion, traditional 'triple' therapy with bismuth and two antibiotics achieved the highest Hp eradication rate and was best tolerated. Recolonisation with Hp was uncommon after eradication. Dyspeptic symptoms improved with Hp eradication in duodenitis and antral gastritis.
根除幽门螺杆菌（Hp）可使消化性溃疡疾病的复发率大幅降低。目前，用于根除Hp的最佳药物方案仍不明确。此外，根除十二指肠炎症和胃窦炎中的Hp是否能改善症状也尚不清楚。本研究的目的是比较三种药物方案根除Hp的疗效，并评估根除Hp是否能改善十二指肠炎症和胃窦炎患者的症状。在内镜检查中发现患有十二指肠溃疡、十二指肠炎症和/或胃窦炎且尿素酶试验（CLO）呈阳性的患者（n = 79）被分配到以下三种方案之一：A. 奥美拉唑20 mg，每日两次，克拉霉素500 mg，每日三次，持续两周（n = 27）；B. 枸橼酸铋钾240 mg，每日两次，持续四周，甲硝唑400 mg，每日三次，阿莫西林500 mg，每日三次，持续一周（n = 26）；C. 奥美拉唑20 mg，每日两次，阿莫西林500 mg，每日三次，持续两周（n = 26）。总之，铋剂与两种抗生素联合的传统“三联”疗法实现了最高的Hp根除率，且耐受性最佳。根除Hp后，Hp再次定植的情况并不常见。十二指肠炎症和胃窦炎患者根除Hp后消化不良症状有所改善。
