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目的 :通过与 7d三联疗法比较 ,观察 3d和 5d三联疗法根除幽门螺杆菌 (Hp)和治疗十二指肠溃疡的疗效。方法 :116例经胃镜检查确诊为十二指肠溃疡活动期并经快速尿素酶试验和血清抗Hp抗体 (ELASE)或病理学检查确定为Hp阳性的病人分为 3组 :3d(3d组 ,39例 )和 5d试验组 (5d组 ,37例 )和 7d对照组 (7d组 ,4 0例 )。 3组均给予三联治疗 :雷贝拉唑 10mg +呋喃唑酮 10 0mg +克拉霉素 2 5 0mg ,每日 2次 ,疗程分别为 3,5和 7d ,后再给予雷贝拉唑 10mg ,每日 1次 ,3d组为 2 5d ,5d组为 2 3d ,7d组为 2 1d。并于抗Hp方案结束后d 2 8～ 5 6内作13C 尿素呼气试验判断Hp根除率的效果。同时在用药后d 1,3,5 ,7,2 1和 35对病人的上腹痛、反酸以及上腹烧灼感等症状进行评估。结果 :10 7例病人完成全部治疗方案 ,9例失访 ,3,5 ,7d组人数分别为 37,35 ,35例。Hp根除率 3d组为 76 % (2 8/ 37) ,5d组为 89% (31/ 35 ) ,7d组为91% (32 / 35 ) ,5d组和 7d组之间差异无显著意义(P >0 .0 5 ) ,且均高于 3d组 (P <0 .0 5 )。3组从用药d 1起均能有效改善病人的上腹痛、反酸、上腹烧灼感等症状 ,各组症状缓解率无显著差异 (P >0 .0 5 )。结论 :3组治疗方案均能有效缓解十二指肠溃疡病人的症状 ,而根除Hp ,5d和 7d疗程较 3d疗程为优
OBJECTIVE: To observe the efficacy of triple and 5d triple therapy for the eradication of Helicobacter pylori (Hp) and the treatment of duodenal ulcer by comparing with 7d triple therapy. METHODS: One hundred and sixteen patients with duodenal ulcer diagnosed by endoscopy and divided into 3 groups according to rapid urease test and serum anti-Hp antibody (ELASE) or pathological examination were divided into 3 groups: 3d (3d group, 39 cases) and 5d experimental group (5d group, 37 cases) and 7d control group (7d group, 40 cases). 3 groups were given triple therapy: rabeprazole 10mg + furazolidone 10 0mg + clarithromycin 250mg, 2 times a day, courses of treatment were 3,5 and 7d, respectively, followed by rabeprazole 10mg, day 1 Times, 3 days was 25 days, 5 days was 2 days and 7 days was 21 days. And in the anti-Hp program after d 2 8 ~ 5 6 13C urea breath test to determine the effect of Hp eradication rate. At the same time d 1,3,5,7,2 1 and 35 after treatment on patients with upper abdominal pain, acid reflux and abdominal burning sensation and other symptoms were evaluated. Results: A total of 107 patients completed the treatment and 9 patients were lost to follow-up. The number of patients in the 3,5,7-day group was 37, 35 and 35, respectively. Hp eradication rate was 76% (2/37) in 3d group, 89% (31/35) in 5d group, 91% (32/35) in 7d group, and no significant difference was found between 5d group and 7d group > 0. 05), and were higher than the 3d group (P <0. 05). The three groups from the d1 medication can effectively improve the patient’s upper abdominal pain, acid reflux, upper abdominal burning sensation and other symptoms, the symptom relief rate was no significant difference (P> 0.05). CONCLUSION: All the three treatment regimens can effectively relieve the symptoms of patients with duodenal ulcer, while the eradication of Hp, 5d and 7d course of treatment is better than 3d