目的 探讨奥美拉唑(Omeprazole)、羟氨苄青霉素(Amoxycillinum)和甲硝唑(Metronidazole)一周短程疗法根除幽门螺杆菌(Hp)的疗效，对Hp相关性活动期十二指肠溃疡(DU)治疗效果和复发的影响，并与两周疗法相比较。方法 将128例Hp阳性的活动期DU患者随机分成两组，A组：奥美拉唑20mg、羟氨苄青霉素1000mg、甲硝唑400mg，每日2次，共1周，奥美拉唑20mg，每日1次，共4周；B组：奥美拉唑20mg、羟氨苄青霉素1000mg、甲硝唑400mg，每日2次，共2周，奥美拉唑20mg，每日1次，共4周。治疗前和治疗后1月、1年各做1次电子胃镜检查，并取活组织做快速尿素酶和Warthin-Starry银染色检查Hp。结果 A、B两组Hp根除率分别为92．19％(59／64)、美拉唑为主，合并羟氨苄青霉素和甲硝唑治疗Hp相关性DU、Hp清除率和DU治愈率高，并能有效预防DU复发。1周短程疗法即可达到治疗目的 ，副作用小，顺应性好，可以取代2周疗法，是目前治疗Hp相关性DU较好的治疗方案。%objectives To evaluate a new triple short therapy with omeprazole, amoxycillinum and metronidazole. Methods One hundred and twenty eight patients with helicobacter pylori( Hp)positive movability duodenal ulcer(DU)were randomised into two groups. Groups A (n = 64) received omeprazole 20mg bid, amoxycillinum 1000mg bid and metronidazole 400mg bid for one week,continuous gived ormpraz ole 20mg daily for forth weeks. Groups B (n=64)recieved omeprazole 20mg bid, amoxycillinum 1000mg bid and metronidazole 400mg bid for two weeks, continuous gived omeprazole 20mg daily for forgh weeks. Edoscopic examination was carried before treatment and one month, twelve months after cessation of the treatment. The Hp slatus was diagnoses by rapid urease test and Wathin - Starry Stain histological. Results Hp eradication rate of A and B two groups was 92.19% (59/64) and 95.31% (61/64) respectively.The cure rate of DU was 93.75% (60/64)and 96.88% (62/64)respectively. There was no statistical significant difference between the two groups for the above results ( P＞0.05 ). The adverse drug reaction rate of two groups was 4.67% (3/64) and 12.50% (8/64) respectively (P＜0.01). The Hp was weather eradication or not, the cure rate of DU was 98.33 % (118/120) and 62.50 % (5/8) respectively；One year later, the DU have a relapse rate in the two groups was 3.33% (4/120 ) and 75.00 % (6/8) respectively(P＜0.01), there being a significant difference between the two groups. Conclusions one week shot triple therapy with omeprazole,amoxycillinum and melronidazole is highly effective,well - tolerated and safe for eradication of Hp infection,and highly cure rate of DU, the eradication of which is associated with a significant reduction in the rate of DU recurrence and occurrence.
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