CAJ | 학술논문

目的:通过与7 d三联疗法比较,观察3 d和5 d三联疗法根除幽门螺杆菌(Hp)和治疗十二指肠溃疡的疗效.方法:116例经胃镜检查确诊为十二指肠溃疡活动期并经快速尿素酶试验和血清抗Hp抗体(ELASE)或病理学检查确定为Hp阳性的病人分为3组:3 d(3 d组,39例)和5 d试验组(5 d组,37例)和7 d对照组(7 d组,40例).3组均给予三联治疗:雷贝拉唑10 mg+呋喃唑酮100 mg + 克拉霉素250 mg,每日2次,疗程分别为3,5和7 d,后再给予雷贝拉唑10 mg,每日1次,3 d组为25 d,5 d组为23 d,7 d组为21 d.并于抗Hp方案结束后d 28～56内作 13C-尿素呼气试验判断Hp根除率的效果.同时在用药后 d 1,3,5,7,21和35对病人的上腹痛、反酸以及上腹烧灼感等症状进行评估.结果:107例病人完成全部治疗方案,9例失访,3,5,7 d组人数分别为37,35,35例.Hp根除率3 d组为76 %(28/ 37),5 d组为89 %(31/ 35),7 d组为91 %(32/ 35),5 d组和7 d组之间差异无显著意义(P> 0.05),且均高于3 d组(P< 0.05).3组从用药d 1起均能有效改善病人的上腹痛、反酸、上腹烧灼感等症状,各组症状缓解率无显著差异(P> 0.05).结论:3组治疗方案均能有效缓解十二指肠溃疡病人的症状,而根除Hp,5 d和7 d疗程较3 d疗程为优.
목적:통과여7 d삼련요법비교,관찰3 d화5 d삼련요법근제유문라간균(Hp)화치료십이지장궤양적료효.방법:116례경위경검사학진위십이지장궤양활동기병경쾌속뇨소매시험화혈청항Hp항체(ELASE)혹병이학검사학정위Hp양성적병인분위3조:3 d(3 d조,39례)화5 d시험조(5 d조,37례)화7 d대조조(7 d조,40례).3조균급여삼련치료:뢰패랍서10 mg+부남서동100 mg + 극랍매소250 mg,매일2차,료정분별위3,5화7 d,후재급여뢰패랍서10 mg,매일1차,3 d조위25 d,5 d조위23 d,7 d조위21 d.병우항Hp방안결속후d 28～56내작 13C-뇨소호기시험판단Hp근제솔적효과.동시재용약후 d 1,3,5,7,21화35대병인적상복통、반산이급상복소작감등증상진행평고.결과:107례병인완성전부치료방안,9례실방,3,5,7 d조인수분별위37,35,35례.Hp근제솔3 d조위76 %(28/ 37),5 d조위89 %(31/ 35),7 d조위91 %(32/ 35),5 d조화7 d조지간차이무현저의의(P> 0.05),차균고우3 d조(P< 0.05).3조종용약d 1기균능유효개선병인적상복통、반산、상복소작감등증상,각조증상완해솔무현저차이(P> 0.05).결론:3조치료방안균능유효완해십이지장궤양병인적증상,이근제Hp,5 d화7 d료정교3 d료정위우.
AIM: To observe the effect of eradicating Helicobacter pylori (Hp) and treating duodenal ulcer by 3 d and 5 d triple therapies through comparing with the 7 d triple therapy. METHODS: One hundred and sixteen patients who were confirmed in duodenal ulcer active period by gastroscopy and Hp positive confirmed by rapid urease test, serum anti-Hp antibody (ELASE) or histological examination were divided into three groups: 3 d group (n=39), 5 d group (n=37) and 7 d controlled group (n=40). All three groups were provided triple therapy first: rabeprazole 10 mg + furazolidone 100 mg + clarithromycin 250 mg, bid, for 3, 5, and 7 d, respectively. Then rabeprazole 10 mg was provided once a day. The period of 3, 5 and 7 d group was 25, 23, and 21 d, respectively. Twenty-eight day to 56 d after taking the medicine, 13C urea breath test was performed to judge the effect of Hp eradication rate. In d 1, 2, 3, 7, 21,35, the symptoms of patients such as epigastralgia, burning pain and acidity were evaluated simultaneously. RESULTS: One hundred and seven patients accomplished all therapy scheme, 9 patients lost. There are 37, 35 and 35 patients in 3,5,7 d group accomplished therapy, respectively. The examination results indicated that the Hp eradication rate of each group was as follows: 3 d group was 76 %(28/37), 5 d group was 89 %(31/35), 7 d group was 91 % (32/35). There was no significant difference between 5 d and 7 d group (P> 0.05). But the Hp eradication rate of the two groups was obviously higher than that of 3 d group (P<0.05). The symptoms such as epigastralgia, burning pain and acidity in all three groups improved since the first day. There was no significant difference in total score descending of symptoms among each group (P>0.05). CONCLUSION: All the three therapy schemes can alleviate symptoms of duodenal ulcer patients efficiently. But as far as eradicating Hp concerned, the scheme of 5 d and 7d is better than that of 3 d.