Magalhaes A F, Macedo C, Hauck J R, Carvalhaes A, De Nucci G, Magna L A, Pedrazzoli J
Gastrocentro, UNICAMP, and Hospital Vera Cruz, Braganca Paulista, Brazil.
Hepatogastroenterology. 1998 Nov-Dec;45(24):2161-4.
BACKGROUND/AIMS: To evaluate whether the addition of 2 weeks of ranitidine to a 1-week oral triple therapy (OTT) regimen improved ulcer healing and H. pylori eradication.
Two hundred and eleven consecutive patients with an endoscopic diagnosis of active duodenal ulcer (DU) and a positive antrum biopsy for H. pylori were enrolled. Those attending the Hospital Vera Cruz (Group A, n=142) received a 14-day course of ranitidine (150 mg after breakfast and dinner) plus a 1-week OTT, consisting of bismuth subcitrate, (240 mg after the 3 meals), tetracycline (500 mg, 10 min before the three meals and at bedtime), and furazolidone (200 mg after breakfast and dinner). Patients from the Hospital das Clinicas (Group B, n=69) received the same OTT as Group A but without ranitidine. Patients underwent endoscopy again on average 40 days (range: 30-60 days) after completing therapy in order to assess ulcer healing and H. pylori status.
Both schedules were equally efficient in eradicating H. pylori with 90% (128/142) eradication in group A, and 84% (58/69) in group B (p=0.2). In contrast, the addition of ranitidine to OTT improved ulcer healing when compared with OTT alone (96%, 137/142, vs. 70%, 48/69; p<0.001).
Our results demonstrate that the association of acid suppression, obtained with 2 week ranitidine administration with OTT improved ulcer healing but did not enhance H. pylori eradication.
背景/目的：评估在1周口服三联疗法（OTT）方案基础上加用2周雷尼替丁是否能改善溃疡愈合及幽门螺杆菌根除情况。
纳入211例经内镜诊断为活动性十二指肠溃疡（DU）且胃窦活检幽门螺杆菌阳性的连续患者。在韦拉克鲁斯医院就诊的患者（A组，n = 142）接受为期14天的雷尼替丁治疗（早餐和晚餐后各150 mg）加1周的OTT，其中包括枸橼酸铋钾（三餐后各240 mg）、四环素（500 mg，三餐前10分钟及睡前服用）和呋喃唑酮（早餐和晚餐后各200 mg）。在临床医院就诊的患者（B组，n = 69）接受与A组相同的OTT，但不加用雷尼替丁。患者在完成治疗后平均40天（范围：30 - 60天）再次接受内镜检查，以评估溃疡愈合情况及幽门螺杆菌状态。
两种方案在根除幽门螺杆菌方面同样有效，A组根除率为90%（128/142），B组为84%（58/69）（p = 0.2）。相比之下，与单独使用OTT相比，OTT加用雷尼替丁可改善溃疡愈合（96%，137/142， vs. 70%，48/69；p < 0.001）。
我们的结果表明，在OTT基础上给予2周雷尼替丁进行抑酸治疗，可改善溃疡愈合，但并未增强幽门螺杆菌的根除效果。
