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目的 :观察以洛赛克为核心的两种四联疗法的幽门螺杆菌 (HP)根除率和溃疡治愈率以及 HP相关性胃十二指肠溃疡治愈后是否仍需应用抑酸剂维持治疗。方法 :(1) 196例病人 (HP相关性胃炎 4 0例 ,HP相关性溃疡 15 6例 )随机分成两组 ,分别给予洛赛克 +灭滴灵 +瑞贝克 (庆大霉素混悬剂 ) +四环素 (A组 )和洛赛克 +灭滴灵 +丽珠得乐 +四环素 (B组 )口服 2周。十二指肠溃疡者继续应用洛赛克 6周 ,胃溃疡和复合性溃疡者则继续用 10周后复查胃镜。 (2 )对溃疡愈合者将 A与 B两组各分为雷尼替丁维持组和对照组 (AR+、AR-、BR+、BR-组 ) ,对溃疡已愈合但 HP未能根除者先加用 2周四联疗法后再用上述方法处理 ,1年后复查胃镜记录其溃疡愈合情况。结果 :A组与 B组的 HP根除率分别为 92 .60 %和 92 .16% (P≥ 0 .0 5 ) ,12周溃疡愈合率分别为 90 .5 4 %和 92 .68% (P≥ 0 .0 5 ) ;AR+ 组与 AR- 组 1年后溃疡持久愈合率分别为 91.67%和 5 8.0 6% (P≤ 0 .0 1) ,BR+组和 BR-组的溃疡持久愈合率分别为 90 .91%和 5 3 .13 % (P≤ 0 .0 0 1)。结论 :(1)以洛赛克为核心的两种四联疗法均具有极高的 HP根除率和极好的治疗溃疡作用。(2 ) HP相关性溃疡在HP根除和溃疡短期治愈后仍需用抑酸剂维持治疗。
Objective: To observe whether H. pylori (HP) eradication rate and ulcer cure rate of two quadruple therapies with Losec as the core and whether the HP-related gastroduodenal ulcer should still be treated with antacid maintenance therapy. Methods: (1) 196 patients (40 HP-related gastritis and 15 6 HP-related ulcer) were randomly divided into two groups: Losec, metronidazole and Rebekac (gentamicin suspension) ) + Tetracycline (group A) and Losec + metronidazole + bezacizumab + tetracycline (group B) for 2 weeks. Duodenal ulcer patients continue to use Losec 6 weeks, gastric ulcer and compound ulcer who continue to review the gastroscope after 10 weeks. (2) The ulcer healing group A and B were divided into two groups: ranitidine maintenance group and control group (AR +, AR-, BR +, BR- group), the ulcer had healed but HP failed to eradicate first With 2 weeks after quadruple therapy and then treated with the above method, one year after the endoscopy to record the healing of ulcers. Results: The HP eradication rates in group A and group B were 92.60% and 92.16%, respectively (P> 0.05). The healing rates of 12-week ulcer were 90.54% and 92.68% (P ≥0.0 5). The ulcer healing rates in AR + group and AR- group were 91.67% and 5 8.06% respectively after 1 year (P≤0.01), and the ulcer healing rates in BR + group and BR- group were respectively 90.91% and 53.13% (P≤0.0001). Conclusions: (1) Both quadruple therapy with Losec as the core have extremely high HP eradication rate and excellent ulcer treatment effect. (2) HP-associated ulcer still need antacid maintenance therapy after HP eradication and ulcer cure for a short time.