上海医科大学 ¹中山医院消化科 ²卫生经济教研组 200032

    国际临床流行病学工作网资金赞助(No. 4164).

    项目负责人 陈世耀,上海医科大学中山医院消化科 200032收搞日期 1996-12-31 接收日期 1997-03-21

    Dual therapy of duodenal ulcer: a randomized controlled trial

    Shi_Yao Chen, Ji_Yao Wang, Xi_De Zhang, Shan_Shen Zhang and Jie Chen

    Department of Gastroenterology, Zhongshan Hospital, Shanghai Medical U niversity, Shanghai 200032, China

    Abstract

    AIM To study the efficacy of dual therapy with 6_week omeprazole(Ome) plus 2_week amoxicillin compared with 2_week amoxicillin plus metronidazole and 6_week tagamet〔(Tag) triple therapy〕 for ulcer healing, Helicobacter pylori (Hp) eradication and ulcer recurrence in duodenal ulcer( DU).

    METHODS Ninety_six consecutive DU patients, confirmed by endosco py with Hp infection (confirmed by urease test and pathology), were randomly all ocated into two groups, OA (dual therapy) group and AMT (triple therapy) group. Patient received one of the therapies and were followed up for six months.

    RESULTS The ulcer healing rates were 93.5% and 83.7% respectiv ely in OA and AMT groups (P=0.27). The eradication rates of Hp were 69.6% and 65.1% (P=0.60) respectively. There was no difference of the recurrence rates between OA group (11.6%) and AMT group (13.9%). The Hp eradication rate was significantly higher in patients with ulcer diameter no more than 1cm (77%) than those with ulcer diameter more than 1cm (50%). No matter which group were they in, OA group: 79.3% vs 52.9% P<0.05; AMT group: 75% vs 46.7% P<0.05. Factors as past history of ulcer, ac companying by acute bleeding, etc. were independent of Hp eradication. But the recurrence rate of patients with Hp positive persisted was higher than those patients with Hp eradicated at the end of 6_month follow_up (37.5% vs 1.85%). There was no difference between two groups concerning the time of pain persisting and the work time lost because of the disease. Moderate or severe side effects were 6.5% in OA group and 8.9% in AMT group. ......