【摘要】 目的 探讨雷贝拉唑与奥美拉唑的根除幽门螺杆菌(Hp)过程中疗程、疗效的对比研究。方法 对经胃镜检查并经快速尿素酶检测和病理检查确定为Hp阳性或经C14呼气试验检测阳性患者采用两种方案治疗对比。即4日的RBCA疗法(第1天雷贝拉唑10mg 2次/d；第2～4天雷贝拉唑10mg，2次/d，果胶铋150mg，2次/d，克拉霉素250mg，2次/d，阿莫西林1000mg，2次/d)。7日的OBCA疗法(奥美拉唑20mg，2次/d，果胶铋150mg，2次/d，克拉霉素250mg，2次/d，阿莫西林1000mg，2次/d)。治疗结束后1个月用C14呼气试验检测法评价Hp感染是否治愈。结果 两组方案治疗效果相近(RBCA组疗法幽门螺杆菌根除率为85.36%，OBCA组疗法根除率为85.16%)，差异无显著性(P>0.05)。结论 雷贝拉唑作为新一代质子泵抑制剂相比奥美拉唑，其抑制胃酸起效快，抑酸作用强，更有利于抗生素在低酸环境下根除幽门螺杆菌，大大缩短了根除幽门螺杆菌的疗程，从药效和药物经济学角度来看均值得推广。

    关键词 雷贝拉唑 奥美拉唑 幽门螺杆菌

    Clinical observation and study of rabeprazole four combined therapy for H.pylori

    Zhang Li,Zhu Shunshi

    The 9th People’s Hospital of Shanghai,Shanghai 200233.

    【Abstract】 Objective To compare treatment result of eradication therapies for H.pylori(Hp) with rabeprazole and omeprazole.Methods Two methods of treatment to compare the result of eradication therapies for Hp were used as follows:All patients were infected by H.pylori that diagnosised by endoscope or by c14 breathe test.One method was treatment of RBCA for 4 days (First day,rabeprazole 10mg bid po;the second day to the fourth days,rabeprazole 10mg bid po,colloidal bismuth subcitrate 150mg bid po,clarithromycin 250mg bid po,amoxicillin 1000mg bid po.).Another one was treatment of OBCA for 7 days(oneprazole 20mg bid po,colloidal bismuth subcitrate 150mg bid po,clarithromycin 250mg bid po,amoxicillin 1000mg bid po.).After be treated and then one month later,the treatment result of eradicantion of Hp by c14 breathe test was observed.Results The treatment result of two method was very similar.(eradication rates of Hp with RBCA was 85.36% as OBCA is 85.16%).Conclusion Rabeprazole as a new drug of proton pump inhibitors (PPIs) is more advanced than omeprazole as follow:it can reduce gastric acid more quickly and be more beneficial to eradicate H.pylori under environment of lower acid density.It also can shorten the period of treatment to eradicate H.pylori. ......