摘要
消化性溃疡病也可以认为是一种与感染有关的疾病，因为根除幽门螺旋杆菌后溃疡不易复发，而且可以减少其并发症。所以对消化性溃疡病的治疗除了针对攻击因子－胃酸而采用抑制药之外，还必须针对幽门螺旋杆菌治疗，即系采用相应的抗菌药物。常用的抗菌药物有阿莫西林、地红霉素、四环素。甲硝唑、替硝唑、呋喃唑酮等。目前有研究表明，质子泵抑制剂（奥美拉唑、兰索拉唑等）也有抗菌活性，此外铋制剂对幽门螺旋杆菌也有很强的杀灭作用。由于单用一种抗菌药物对根除幽门螺旋杆菌疗效不佳，故通常采用多种抗菌药物联合治疗。目前常用精典的三联是胶体次枸橼酸铋＋甲硝唑＋阿莫西林（根除率为８５％），但是药物不良反应大（３０％）。临床研究表明如果改为四联用药，可以消除或减少药物不良反应（如：胶体次枸橼酸铋＋甲硝唑＋阿莫西林＋四环素），其对幽门螺旋杆菌根除率可达９０～１００％。但是幽门螺旋杆菌对甲硝唑易产生耐药，故奥美拉唑＋阿莫西林（新二联）以及奥美拉唑＋阿莫西林＋地红霉素等新的联合用药法引起了人们的关注。
Peptic ulcer may be regarded as a kind of infectious diseases, this is because,after the eradication of the pathogen Helicobacter pylori(H. pylori), the recurrence rate of peptic ulcer and complications will be greatly reduced. In addition to the use of gastric acid suppressers in the treatment of gastric ulcer, related antibacterial drugs must be applied in the eradication of H. pylori.Amoxicillin, clarithromycin, tetracycline, metronidazole, tinidazole,and furazolidone were the most commonly used drugs. Present study had indicated: proton pump inhibitor omeprazole, lansoprazole had antibacterial activities against H. Pylori, while the bismuth preparations had the excellent an tibacterial activities. Due to the poor clinical efficacy with single use of antibacterial agents, combinations of these drugs were often used in clinic, such as bismuth plus metronidazole and amoxicillin(Triple), but their adverse drug reactions were relatively high (more than 30% ).In order to minimize these adverse reactions, bismuth+metranidazole+amoxicillin+tetracycline(quarterly) was used with eradication rate of H. pylori up to 90-100%, but bacterial resistance to metranidazole was often encountered. Omeprazole plus amoxicillin and clarithromycin are now arousing most interests of physicians.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
1996年第4期224-230,共7页
The Chinese Journal of Clinical Pharmacology
关键词
幽门螺旋杆菌
溃疡病
阿莫西林
地红霉素
甲硝唑
Helicobacter pylori
amoxicillin
clarithromycin
metronidazole
tetracycline omeprezole
