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| 題 名 | A Multicenter Study on Eradication of Helicobacter pylori Infection in Patients with Duodenal Ulcer by Lansoprazole-Antibiotics Combined Therapy=以Lansoprazole合併抗生素清除幽門螺旋桿菌之多中心研究 |
|---|---|
| 作 者 | 楊智欽; 楊國卿; 許重得; 王朝欣; 郭長豐; 王德宏; | 書刊名 | 微免與感染雜誌 |
| 卷 期 | 32:1 1999.03[民88.03] |
| 頁 次 | 頁1-8 |
| 分類號 | 415.83 |
| 關鍵詞 | 抗生素; 幽門螺旋桿菌; Helicobacter pylori; Lansoprazole; Eradication; Adverse effect; |
| 語 文 | 英文(English) |
| 中文摘要 | 本多中心研究目的在找出一個對幽門螺旋桿菌(Helicobacter pylori)感染具有高 清除率同時有高服藥配合度、 低抗藥性、 低副作用、 低成本的治療處方。 總共 297 例 H.pylori 陽性之潰瘍患者， 隨機分為五組接受 lansoprazole 每天 30mg 合併下列組合： A組：amoxicillin(AM)500mg 及 metronidazole(MZ)500 mg bid 1 週；B 組：MZ 同 A 組 及 clarithromycin(CM) 250 mg bid 1 週；C 組:AM 同 A 組， CM 同 B 組 1 週； D 組：同 C 組，但治療 2 週；E 組：CM 較 D 組倍增為 500 mg bid 治療 2 週。病人於治療前及停 藥後 4 ∼ 6 週均接受胃鏡檢查， 觀察潰瘍情況並於胃之前庭部及體部取組織切片做 CLO test、細菌培養及組織學檢查。 對拒絕胃鏡複檢查者，以�C C 尿素呼氣試驗來代替。我們 用 E-test 來評估 H. pylori 菌株對 MZ 及 CM 之抗藥性。結果共有 253 例完成本研究。 由 A 至 E 五組之 H. pylori 清除率分別無 75%、80%、78%、92% 及 96%。 E 組明顯高於 A、B、C 三組但和 D 組無差異。具 MZ 抗藥性之 H. pylori 菌株有 29%，具 CM 抗藥性者 有 4%。 其中 MZ 抗藥性的存在，會明顯降低含此藥物之治療組的療效。各組配合度無差異 性。 副作用發生率各為 8.7%、16%、18%、20% 及 19%，但多為程度輕微者，其中以稀便、 味覺不佳及頭暈較多見。 治療費用在各組依序約為新臺幣 1358、1792、 1624、 2282 和 3374 元。綜合以上結果，我們認為 D 組為五組中最符合我們期望之治療組合。 |
| 英文摘要 | The aim of this prospective randomized multicenter study was to find out if there is one or several promising regimens containing lansoprazole with various combinations of antibiotics which have a high eradication rate of Helicobacter pylori, few side-effects, good patient compliance, and relative low cost if possible. Two hundred and ninety-seven patients with H. pyloripositive duodenal ulcer were enrolled and randomly allocated into one of the five treatment groups:1)group A:received lansoprazole 30 mg once daily for 2 weeks plus amoxicillin (AM) 500 mg and metronidazole (MZ) 500 mg twice daily for one week in the first week; 2)group B: the AM in group A was replaced by clarithromycin (CM) 250 mg; 3)group C:the MZ in group A was replaced by CM 250 mg; 4)group D:the AM and CM in group C was used for 2 wk; 5) group E: the CM in group D was doubled to 500 mg twice daily. All patients received endoscopies pre-and 4 ∼ 6 weeks post termination of treatment. H. pylori was detected by culture, histology and rapid urease test (CLO test). �C C-urea breath test was performed if the patients refused the second endoscopy. The E-test was adopted to evaluate the MZ and CM resistance of H. pylori. Totally, 253 patients completed the study. The eradication rate of groups A, B, C, D and E were 75%， 80%, 78%,92%,and 96%, respectively. The eradication rate of group E was significantly higher than that of groups A, B, or C. There were no significant differences of eradication rates between the groups D and E. Sixty-seven cases (28.8%) were MZ-resistant. The difference of eradication rates between MZ-S and MZ-R patients was significant in group A (85.3% vs. 42.9%) and in the combination of groups A and B (83.8% vs. 59.4%). Good compliance (defined as taking>90% of medications) was seen in more than 90% of cases in each group. Triple therapy containing lansoprazole 30 mg once daily, AM 500 mg and CM 250 mg twice daily for two weeks is a promising regimen which reaches a high eradication rate, avoids MZ resistance, and has very good patient compliance at an acceptable cost. |
本系統中英文摘要資訊取自各篇刊載內容。