摘要
目的 :观察短程低剂量“新三联”对消化性溃疡的胃粘膜保护作用并探讨其可能的机制。方法 :采用前瞻性、随机双盲、安慰剂对照研究 ,40例HP阳性消化性溃疡被随机分为两组 :A组 (新三联 ) :达克普隆 30mg ,每日 1次 +阿莫西林 5 0mg ,每日 2次 +克拉霉素 2 5 0mg ,每日 2次 ,连服 10天 ;B组 (安慰剂 ) :胃舒平 3片 ,每日 2次 ,连服 2 8天。治疗前及治疗后 4周复查胃镜 ,检测胃粘膜磷脂、氨基已糖和血清表皮生长因子 (EGF)。结果 :HP根治率、溃疡愈合率在A组 ( 92 %、88% )明显高于B组 ( 0 .0 %、2 0 % ) (均P <0 .0 1)。具有较高HP根治率的A组治疗后氨基已糖含量 (mg/g48.7± 18.4)高于治疗前 (mg/g 41.7± 15 .6 ,P <0 .0 5 ) ,磷脂和EGF治疗前较治疗后有所提高 ,但无统计学意义。治疗后组间比 ,A组EGF( 0 .5 8± 0 .2 )高于B组 ( 0 .46± 0 .2 ,P <0 .0 2 5 ) ;B组磷脂、氨基已糖和EGF治疗前后无明显变化。结论 :短程低剂量“新三联”疗法具有一定的胃粘膜保护作用。可能主要与其根除HP感染有关。另外 ,阿莫西林和兰索拉唑通过增加胃粘膜血流进而改善粘膜磷脂、氨基已糖和内源性EGF的代谢 。
Purpose: To investigate protective effect of shor term lower*.dose triple therapy on gastric mucosa of peptic ulcer patients and its possible mechanism. Methods: This was a prospective, randomized, double*.blind, placebo controlled study. 40 patients with active peptic ulcer and HP infection, randomly received one of the two regimens: New triple therapy (group A): lansoprazole 30 mg qd, plus clarithromycin 250 mg bid, plus amoxycillin 500 mg bid, after meals for 10 days; Placebo (group B): gastropine 3tab bid, for 4wk. Before and 4wk after completing treatment, antral mucosa phospholipid, hexosamine and serum epidermal growth factor (EGF) were measured in all patients. Results: The eradication rate of HP and the healing rate of ulcer in group A (92% and 88%) were significantly higher than those in group B ( 0.0% and 20%,P<0.01,respectively). Comparing with before treatment, the hexosamine content (mg/g) of gastric mucosa after treatment was significantly increased(48.7±18.4 vs 41.7±15.6,P< 0.05 ), the phspholipid content(mg/g) of gastric mucosa and the EGF content (μg/L) of serum after treatment was slightly increased (P>0.05) in group A. The above indexes did not obviously change in group B. Conclusion: The short*.term lower dose triple therapy had a cytoprotective effect. It may be related to preventing gastric mucosal phospholipid, hexosamine and endogenous EGF from being broken by eradicating HP infection and increasing the gastric mucosal blood flow.
出处
《临床消化病杂志》
2000年第3期106-108,共3页
Chinese Journal of Clinical Gastroenterology
关键词
兰索拉唑
克拉霉素
阿莫西林
胃粘膜
Triple therapy/pharmacodynamics Lansoprazole Clarithromycin Amoxycillin Gastric mucosa
