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三联疗法对非糜烂性反流病合并H pylori感染患者预后的影响

Efficacy of triple therapy and its effect on prognosis of H pylori infected patients with non-erosive reflux disease
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摘要 目的:探讨幽门螺杆菌(H pylori)根除对非糜烂性反流病(non-erosive reflux diseage,NERD)合并H pylori感染患者疗效及预后.方法:120例非糜烂性反流病合并H pylori感染患者随机分为:对照组60例,仅口服洛赛克(20 mg,2次/d)1 wk;三联疗法组60例:口服洛赛克(20 mg)和克拉霉素(500 mg)及阿莫西林(500 mg),均每天2次,连续1 wk,1 wk后非糜烂性症状缓解患者,开始口服洛赛克20 mg/d的维持治疗阶段至3 wk:试验结束后6 mo均行胃镜复查及^(13)C呼气试验.结果:试验结束后三联疗法组57例患者H pylori阴性(95.0%),对照组5例转阴(8.3%),两组H pylori根除率差异显著(P<0.01);对照组患者残胃萎缩及残胃肠化较H pylori根除组明显增多(P<0.05),三联疗法但对反流症状烧灼感及进食后梗阻或异物感的改善不明显(P>0.05)结论:三联疗法根除H pylori后对非糜烂性反流病合并H pylori感染患者的胃窦部的肠化生及不典型增生有防治疗效,但对反流症状烧灼感及进食后梗阻或异物感的改善不明显. AIM: To investigate the efficacy of triple therapy and the effect of H pylori eradication on the prognosis of patients with non-erosive reflux disease (NERD). METHODS: One-hundred and twenty H pylori infected patients with NERD were randomly and averagely divided into group A and B. The patients in group A received triple therapy (20 mg Losec plus 500 mg Clarithromycin plus 500 mg Amoxicillin, twice a day) for 1 wk, and the ones in group B served as the controls (treated with 20 mg Losec twice a day). From week 2, the patients, whose symptoms of non-erosive reflux disease were alleviated, in both groups were orally treated only with 20 mg Losec once a day until the end of week 3. Gastric endoscopy and 13C breath test were performed at the end of 12 mo. RESULTS: 13C breath test showed that the rate of H pylori eradication was significantly higher in group A than that in group B (95% vs 8.3%, P〈0.01). The degrees of corpus atrophy and intestinal metaplasia were also markedly alleviated in group A (P〈0.01). However, the scores for the symptoms such as heartburn or swallow abnormality had no significant difference between the two groups (P〉0.05). CONCLUSION: Triple therapy is effective in the eradication of H pylori and treatment of intestinal metaplasia and corpus atrophy, but not in the improvement of heartburn or swallow abnormality.
出处 《世界华人消化杂志》 CAS 北大核心 2006年第19期1924-1927,共4页 World Chinese Journal of Digestology
关键词 三联疗法 Hpylori根除 非糜烂性反流病 疗效 Helicobacter pylori Non-erosive refluxdisease Prognosis Efficacy
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