Catalano F, Catanzaro R, Bentivegna C, Brogna A, Condorelli G, Cipolla R
Gastroenterology and Digestive Endoscopy Service, University of Catania, Italy.
Aliment Pharmacol Ther. 1998 Jan;12(1):59-62. doi: 10.1046/j.1365-2036.1998.00270.x.
To compare the efficacy and safety of triple therapy with omeprazole plus amoxycillin and clarithromycin vs. ranitidine bismuth citrate plus amoxycillin and clarithromycin in the treatment of Helicobacter pylori-associated duodenal ulcers.
Eighty-one patients with duodenal ulcers were randomized to the following treatments: 39 cases with amoxycillin 1 g b.d. and clarithromycin 500 mg b.d. for 1 week plus omeprazole 20 mg b.d. for 2 weeks (omeprazole + amoxycillin + clarithromycin (OAC)), and 42 cases to the same regimen of amoxycillin and clarithromycin for 7 days plus ranitidine bismuth citrate 400 mg b.d. for 2 weeks (ranitidine bismuth citrate + amoxycillin + clarithromycin (RbAC)). Upper gastrointestinal endoscopy was performed together with a rapid urease test and histological examination of antral and corpus biopsy samples prior to treatment and 4 weeks after the end of therapy.
Thirty-four patients in the OAC group and 38 in the RbAC group completed the treatment and 4-week follow-up. H. pylori was eradicated in 30 of 34 patients (88%) in the OAC group and in 32 of 38 patients (84%) in the RbAC group according to a per-protocol analysis (P = N.S.). Thirty-three (97%) patients treated with OAC and 36 (95%) treated with RbAC presented healed duodenal ulcers at 4 weeks (P = N.S.). On an intention-to-treat basis there was no difference in H. pylori eradication between the OAC (77%) and RbAC groups (76%); duodenal ulcer healing was achieved in 85 and 86% of patients in the OAC and RbAC groups, respectively (P = N.S.).
The OAC and RbAC triple therapy regimens proved equally effective in both H. pylori eradication and in duodenal ulcer healing.
比较奥美拉唑联合阿莫西林和克拉霉素与枸橼酸铋雷尼替丁联合阿莫西林和克拉霉素三联疗法治疗幽门螺杆菌相关性十二指肠溃疡的疗效和安全性。
81例十二指肠溃疡患者随机分为以下治疗组：39例患者口服阿莫西林1g，每日2次，克拉霉素500mg，每日2次，共1周，加用奥美拉唑20mg，每日2次，共2周（奥美拉唑+阿莫西林+克拉霉素（OAC））；42例患者口服相同方案的阿莫西林和克拉霉素7天，加用枸橼酸铋雷尼替丁400mg，每日2次，共2周（枸橼酸铋雷尼替丁+阿莫西林+克拉霉素（RbAC））。治疗前及治疗结束后4周进行上消化道内镜检查，同时进行快速尿素酶试验及胃窦和胃体活检标本的组织学检查。
OAC组34例患者和RbAC组38例患者完成了治疗及4周随访。根据符合方案分析，OAC组34例患者中有30例（88%）幽门螺杆菌被根除，RbAC组38例患者中有32例（84%）幽门螺杆菌被根除（P=无统计学意义）。4周时，OAC组33例（97%）患者和RbAC组36例（95%）患者十二指肠溃疡愈合（P=无统计学意义）。在意向性分析中，OAC组（77%）和RbAC组（76%）幽门螺杆菌根除率无差异；OAC组和RbAC组分别有85%和86%的患者十二指肠溃疡愈合（P=无统计学意义）。
OAC和RbAC三联疗法在根除幽门螺杆菌和十二指肠溃疡愈合方面同样有效。
