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目的:探讨埃索美拉唑、胶体果胶铋加克拉霉素及呋喃唑酮治疗难治性十二指肠球部溃疡的临床疗效。方法:将45例幽门螺杆菌(Hp)阳性的难治性十二指肠球部溃疡患者随机分为2组,治疗组(n=25)口服埃索美拉唑40mg,bid,1周后40mg,qd,疗程3周;胶体果胶铋0.1g,tid,疗程4周;克拉霉素0.5g,bid,疗程1周;呋喃唑酮0.1g,bid,疗程1周。对照组(n=20)口服法莫替丁20mg,bid,疗程4周,胶体果胶铋0.1g,tid,疗程4周;克拉霉素0.5g,bid,疗程2周;呋喃唑酮0.1g,bid,疗程2周。观察其临床症状的改善情况,以及疗程结束后复查胃镜来判断其溃疡愈合率、Hp清除率和停药4周后Hp根除率。结果:治疗组镜下溃疡痊愈23例(92.0%)、显效2例(8.0%)。Hp清除率为100%、Hp根除率为92.0%。临床症状的改善:显效24例(96.0%),有效1例(4.0%),总有效率为100%,无明显不良反应,与对照组相比,其疗效差异有显著性(P<0.05或P<0.01)。结论:埃索美拉唑、胶体果胶铋联合克拉霉素和呋喃唑酮可有效根除Hp,促进溃疡愈合,对难治性十二指肠球部溃疡有很好疗效。
Objective: To investigate the clinical efficacy of esomeprazole, colloidal bismuth pectin plus clarithromycin and furazolidone in the treatment of refractory duodenal ulcer. Methods: Forty-five patients with Helicobacter pylori (Hp) -receiving refractory duodenal ulcer were randomly divided into two groups. The treatment group (n = 25) received oral esomeprazole 40 mg once daily for 1 week 40mg, qd, treatment for 3 weeks; colloidal bismuth pectin 0.1g, tid, treatment for 4 weeks; clarithromycin 0.5g, bid, treatment for 1 week; Furazolidone 0.1g, bid, treatment for 1 week. Control group (n = 20) oral famotidine 20mg, bid for 4 weeks, colloidal bismuth pectin 0.1g, tid for 4 weeks; clarithromycin 0.5g, bid for 2 weeks; furazolidone 0.1g, bid , Treatment for 2 weeks. Observed the improvement of clinical symptoms, as well as the end of the treatment of gastroscopy review to determine the ulcer healing rate, Hp clearance rate and Hp eradication rate after 4 weeks of withdrawal. Results: In the treatment group, 23 cases (92.0%) of the ulcers were cured and 2 cases (8.0%) were cured. Hp clearance rate was 100%, Hp eradication rate was 92.0%. The improvement of clinical symptoms was markedly improved in 24 cases (96.0%), 1 (4.0%) effective and 100% effective in total, with no significant adverse reactions compared with the control group (P <0.05 or P <0.01). Conclusion: Esomeprazole, colloidal bismuth pectin combined with clarithromycin and furazolidone can effectively eradicate Hp, promote ulcer healing, and have a good curative effect on refractory duodenal ulcer.