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題 名 | Clarithromycin in the Combination Therapy for the Eradication of Helicobacter Pyloriin Peptic Ulcer Disease=Clarithromycin用於消化性潰瘍病人幽門桿菌的合併療法之除菌效果 |
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作 者 | 羅文景; 林懷正; 王琨; 彭清霖; 李壽東; | 書刊名 | 中華醫學雜誌 |
卷 期 | 59:3 1997.03[民86.03] |
頁 次 | 頁171-176 |
分類號 | 415.526 |
關鍵詞 | 幽門桿菌; 消化性潰瘍; 三合療法; Clarithromycin; Helicobacter pylori; Omeprazole; Peptic ulcer; Triple therapy; |
語 文 | 英文(English) |
中文摘要 | 背景:Clarithromycin,一種新的macrolide抗生素,已經被證實能有效治療幽門桿菌,但是在中國患者其療效和最佳劑量仍不明瞭。 方法:1995 年一月至 1996 年二月,我們搜集七十五位幽門桿菌陽性的十二指腸潰瘍患者。隨機分為三組,第一組接受nizatidine三百毫克每天兩次加上amoxicillin五百毫克每天四次,clarithromycin五百毫克每天三次十四天; 第貳組接受omeprazole二十毫克每天兩次加上clarithromycin 五百毫克每天三次十四天;第三組接受三合療法(bismuth subsalicylate三百毫克每天四次加上 amoxicillin 五百毫克每天四次和 metronidazole 二百五十毫克每天四次共十四天);接著所有患者接受第貳型抗組織氨劑六週。 結果:幽門桿菌的清除率,第一組為 80%(20 / 25),第貳組為76%(19 / 25),第三組為88%(22 / 25)(三組比較P值大於0.05)。八週潰瘍癒合率第一組為 84%(21 / 25),第貳組為 80%(20 / 25), 第三組為80% (20 / 25)(三組比較P值大於0.05)。藥物副作用第一組有10人(40%),第貳組有7人(28%),第三組有4人(16%),接受三合療法有較少的藥物副作用,但在統計上無顯著差異(三組比較p值大於0.05)。 結論:Nizatidine 加上amoxicillin,clarithromycin三合療法和omeprazole加上clarithromycin二合療法皆可達到良好的清除幽門桿菌效果,可為十二指腸潰瘍患者提供一種新的除菌選擇。 |
英文摘要 | Background: Clarithromycin is a new macrolide antibiotic which is known to be highly effective in eradicating Helicobacter pylori (H. pylori). In Chinese, the role of clarithromycin for H. pylori is still unclear. Methods: Between January 1995 and February 1996, 75 patients with active H. pylori-positive duodenal ulcer were enrolled in this study. Three groups were randomized to have (1) 2x150 mg nizatidine twice daily, 2x250 mg amoxicillin four times daily, and 2x250 mg clarithromycin three times daily for two weeks (niz-amox-clar group, N=25); or (2) 20 mg omeprazole twice daily plus 2x250 mg clarithromycin three times daily for two weeks (ome-clar group, N=25); or (3) 300 mg bismuth subsalicylate four times daily, and 2x250 mg amoxicillin four times daily, 250 mg metronidazole four times daily for two weeks (triple therapy group, N=25). All the patients received H2 receptor antagonist (150 mg nizatidine or ranitidine, or 400 mg cimetidine, twice daily) for the consecutive six weeks. Results: The eradication rate of H. pylori eight weeks after the entry of study was 80%(20/25) in the niz-amox-clar group, 76%(19/25) in the ome-clar group, 88%(22/25) in the triple therapy group (p > 0.05 among the three groups). The ulcer healing rates eight weeks after the entry of study for the niz-amox-clar, the ome-amox, and the triple therapy groups were 84%(21/25), 80%(20/25), and 80%(20/25), respectively (p > 0.05 among the three groups). The number of patients experiencing adverse effects in the niz-amox-clar group, the ome-clar group, and the triple therapy group were 10(40%), 7(28%), and 4(16%), respectively (p > 0.05 among the three groups). Conclusions: Both nizatidine/amoxicil-lin/clarithromycin and omeprazole/clarithro-mycin regimens can achieve good eradication rates and may provide an effective alternative anti-H. pylori treatment in duodenal ulcer diseases. |
本系統中英文摘要資訊取自各篇刊載內容。