雷贝拉唑与奥美拉唑短程三联或四联疗法根除幽门螺杆菌的随机对照研究被引量：5

Rabeprazole-based vs.omeprazole-based short-term triple or quadruple therapy for the eradication of Helicobacter pylori infection:a randomized parallel-controlled study

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摘要目的　评估雷贝拉唑 (R)与奥美拉唑 (O)在含有克拉霉素 (C)和阿莫西林 (A)的短程三联或加用呋喃唑酮 (F)的超短程四联根除幽门螺杆菌 (Hp)方案中的疗效。方法　将 180例Hp阳性、内镜检查确诊为消化性溃疡或非溃疡性消化不良的患者随机分为雷贝拉唑治疗组 (R组 )和奥美拉唑对照组 (O组 )。R组和O组又分别分为RAC 7天 /OAC 7天组、RAC 5天 /OAC 5天组和RACF 3天 /OACF 3天组 ,每天服药 2次 ,疗程分别为 7天、5天和 3天。各组患者在治疗前 1周内和治疗后 4～ 8周分别经内镜活组织学检查、快速尿素酶试验和1 3 C UBT检测Hp感染状况并评估溃疡合情况。结果　在Hp根除率方面 ,根据意图治疗分析 (ITT)和按试验方案 (PP)分析 ,R组总的Hp根除率均显著高于O组 (P <0 .0 5 ) ;RACF 3天的Hp根除率显著高于OACF 3天组 (P <0 .0 5 ) ,OACF 3天组的Hp根除率显著低于OAC 7天组 (P <0 .0 1)和OAC 5天组 (P <0 .0 5 ) ,RACF 3天组与RAC 7天组和RAC 5天组比较差异无显著性。各组间溃疡愈合率比较差异无显著性。结论　雷贝拉唑与阿莫西林、克拉霉素联合的短程三联或与阿莫西林、克拉霉素和呋喃唑酮联合的短程四联疗法具有良好的耐受性 ,其超短程四联 3天疗法的Hp根除率和溃疡愈合率均接近于三联 7天和 5天疗法 ,显著优于以? Objective To compare and evaluate the efficacy of rabeprazole(R) vs.omeprazole (O) in short term triple therapy contained clarithromycin(C),amoxicillin(A) or quadruple therapy contained C,A and furazolidone(F) for the eradication of Helicobacter pylori (Hp) infection.Methods 180 patients with peptic ulcer or functional dyspepsia and Hp infection proven by rapid urease test,histology or/and 13 C urea breath test(UBT) were randomly divided into group R and group O.All of patients in both group R and group O were assigned to receive RAC7/OAC7,RAC5/OAC5 or RACF3/OACF3,twice daily for 7 days,5 days or 3 days,respectively;then either R 10mg qd or O 20mg qd for another 14 days.The eradication rates of Hp and the healing rates of duodenal or gastric ulcer were evaluated by the second endoscopy and 13 C UBT 4 8 weeks after completion of treatment.The symptom relief and side effect were also evaluated during treatment.Results There are 9 patients dropped out.Based on intention to treat (ITT) and protocol analysis,the eradication rate of Hp in group R was significant higher than that in group O(85.6%/91.7% vs. 73.3%/78.6%, P <0.05);the difference between RACF3 group and OACF3 group was especially significant(80.0%/85.7% vs. 53.3%/59.3%, P <0.05);Within group O,the eradication rate of Hp of OACF3 group was significant lower than that of OAC7 and OAC5 group (53.3%/59.3% vs. 86.7%/92.9%, P <0.01;53.3%/59.3% vs. 80.0%/82.8%, P <0.05).There was no statistically significant difference on the ulcer healing rates and on the side reaction rates in all treatment groups( P >0.05).Conclusions Rabeprazole based triple or quadruple therapy may effectively eradicate Hp infection and heal the peptic ulcer with good tolerance and submissiveness;the eradication rate of Hp and ulcer healing rate of its ultra short term quadruple therapy(RACF3) was similar to its triple 7 days therapy and triple 5 days therapy and superior to omeprazole based quadruple 3 days therapy.

作者靖大道汪佩文陈洁周怡和徐敏王兴鹏

机构地区上海交通大学附属第一人民医院消化科

出处《临床内科杂志》 CAS 北大核心 2004年第7期455-457,共3页 Journal of Clinical Internal Medicine

关键词幽门螺杆菌感染/药物疗法雷贝拉唑奥美拉唑阿莫西林呋喃唑酮 Helicobacter pylori infection/drug theapy Rabeprazole Omeprazole Amoxicillin Furazolidone

分类号 R573.1 [医药卫生—消化系统]

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1Pantoflikova D, Dorta G,Jornod P, et al. Identification of the characteristics influencing the degree of antisecretory activity of PPIs. Gastroenterology,2000,118 (4) :5895-5901.
2Stedman CA, Barclay ML. Comparison of the pharma cokinetics, acid suppression and efficacy of proton pump inhibitors. Aliment Pharmacol Ther,2000,14:963-978.
3Hawkey C J, Atherton JC, Treichel HC, et al. Safety and efficacy of 7-day rabeprazole- and omeprazole-based triple therapy regimens for the eradication of Helicobacter pylori in patients with documented peptic ulcer disease. Aliment Pharmacol Ther, 2003,17 (8): 1065 -1074.
4Wong BC,Wong WM,Yee YK,et. al. Rabeprazole-based 3-day and 7-day triple therapy vs. omeprazole-based 7-day triple therapy for the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther,2001,15(12) :1959-1965.
5郑青,吴叔明,柯美云,刘晓红,刘南植,但自力,苌新明,房殿春,肖天力,萧树东.雷贝拉唑与奥美拉唑三联疗法根除幽门螺杆菌多中心、随机、双盲、平行对照研究[J].胃肠病学,2002,7(5):272-276. 被引量：62

二级参考文献16

1Lam SK, Talley NJ. Report of the 1997 Asia Pacific Consensus on the management of Helicobacterpylori infection. J Gastroenterol Hepatol, 1998,13: 1～12.
2European Helicobacter pylori Study Group. Current European concepts in the management ofHelicobacter pylori infection. The Maastricht Consensus Report. Gut, 1997, 41: 8～13.
3Miwa H, Ohkura R, Murai T, Sato K, NagaharaA, Hirai S, Watanabe S, Sato N. Impact of Rabeprazole, a new proton pump inhibitor, in tripletherapy of Helicobacter pylori infection-comparison with omeprazole and lansoprazole. AlimentPharmacol Ther, 1999, 13: 741～746.
4Lind T, Veldhuyzen van Zanten S, Unge P, SpillerR, Bayerdorffer E, O'Morain C, Bardhan KD, Bradette M, Chiba N, Wrangstadh M, Cederberg C,Idstrom JP. Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: the MACH I Study.Helicobacter, 1996, 1: 138～144.
5Besancon M, Simon A, Sachs G, Shin JM. Sites ofreaction of the gastric H, K-ATPase with extracytoplasmic thiol reagents. J Biol Chem, 1997,272: 22438～22446.
6Dekkers CP, Beker JA, Thjodleifsson B, Gabryelewicz A, Bell NE, Humphries TJ. Comparison[correction of Double-blind, Placebo-Controlledcomparison] of rabeprazole 20 mg versus omeprazole 20 mg in the treatment of active gastric ulcer- a European multicentre study. The European Rabeprazole Study Group. Aliment Pharmacol Ther,1998, 12: 789～795.
7Hongo M, Kimpara T, Moriyama S, Ohara S, SoneS, Tamura T, Asaki S, Toyota T. Effect of rabeprazole (E3810), a novel proton pump inhib- itor, oningastric pH in healthy volunteers. Tohodu J ExpMed, 1998, 186: 43～50.
8Williams MP, Pounder RE. Review article: thepharmacology of rabeprazole. Aliment PharmacolTher, 1999, 13 (Suppl 3): S3～S10.
9Thjodleifsson B, Beker JA, Dekkers C, Bjaaland T,Finnegan V, Humphries TJ. Rabeprazole versusomeprazole in preventing relapse of erosive or ulcerative gastroesophageal reflux disease: a doubleblind, multicenter, European trial. The EuropeanRabeprazole Study Group. Dig Dis Sci, 2000, 45:845 ～853.
10Dekkers CP, Beker JA, Thjodleifsson B, Gabryelewicz A, Bell NE, Humphries TJ. Comparison of rabeprazole 20 mg versus omeprazole 20 mg in thetreatment of active duodenal ulcer: a Europeanmulticentre study. Aliment Pharmacol Ther, 1999,13: 179～186.