【摘要】 目的:观察阿奇霉素三联疗法根除十二指肠球部溃疡病人的幽门螺杆菌(Hp)的临床疗效,对比阿奇霉素三联疗法一周与两周方案的疗效差别。方法:69例经胃镜检查证实为十二指肠球部溃疡并有Hp感染的病人,随机分为两组。A组(35例)口服奥美拉唑40mg每日1次,共2周;阿奇霉素500mg/d,仅疗程开始的头3日口服;阿莫西林500mg口服,每日4次,共2周。B组(34例)奥美拉唑与阿奇霉素的剂量和疗程同A组,阿莫西林500mg口服,每日3次,共1周。疗程结束后停用所有抗生素,4周后胃镜复查溃疡愈合情况,14C-尿素呼气试验复查Hp根除情况。结果:Hp根除率:A组和B组分别为89%(31/35)、85%(29/34),两组比较无显著性差异(P>0.05);溃疡愈合率:A组和B组分别为97%(28/29)、94%(29/31),两组比较无显著性差异(P>0.05);全部病人均完成治疗,仅2例出现恶心,1例轻度腹泻,总不良反应率为4%。结论:①阿奇霉素三联疗法具有Hp根除率高、安全性好、不良反应少及依从性好的优点;②阿奇霉素三联疗法一周方案与两周方案比较疗效相当;③阿奇霉素可作为根除Hp治疗方案中的一个新选择。更多还原

【Abstract】 Objective:To study the efficacy of azithromycin based triple therapy on eradication of helicobacter pylori (H. pylori) in duodenal ulcer and to compare the efficacy of 1 week regimen and 2 week regimen. Methods:69 patients with active duodenal ulcers and established H. pylori infection were randomely divided into two groups. 35 patients received omeprazole 40 mg qd plus amoxicillin 500 mg qid for 14 days and azithromycin 500 mg qd for the first 3 days (group A).34 patients (group B) were given with omeprazole 40 mg qd for 14 days plus amoxicillin 500 mg tid for 7 days and azithromycin 500 mg qd for the first 3 days. H.pylori status was determined by 14C urea breath test (14C UBT) and ulcer healing was assassed by endoscopy before and 4 weeks after therapy. Results:H. pylori infection was eradicated 4 weeks after treatment in 31 of the 35 patients in group A(89%),and in 29 of the 34 patients in group B(85%),with no statistical difference(P>0.05). After 4 weeks,duodenal healing rates were 97%(28/29)in group A and 94(29/31)in the group B(P>0.05).Side effects were mild (only 4%). They did not interfere with compliance. Conclusion:One week triple therapy with azithromycin(for first 3 days),amoxicillin and omeprazole is highly effective in eradicating H. pylori and curing ulcer. This regimen is safe and well tolerated.更多还原