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浙江大学学报（医学版） 2011年第3期40卷 327-331页

作者：徐美华张桂英李常娟中南大学湘雅医院消化科湖南长沙410008

目的:评价含铋剂四联方案(耐信+克拉霉素+阿莫西林+丽珠得乐)治疗消化性溃疡或慢性胃炎Hp感染患者的疗效,寻找高效、经济的一线Hp根除方案。方法:①136例消化性溃疡或慢性胃炎Hp感染初治患者,随机分为四联组(67例)和三联组(69例);四联... 详细信息

目的:评价含铋剂四联方案(耐信+克拉霉素+阿莫西林+丽珠得乐)治疗消化性溃疡或慢性胃炎Hp感染患者的疗效,寻找高效、经济的一线Hp根除方案。方法:①136例消化性溃疡或慢性胃炎Hp感染初治患者,随机分为四联组(67例)和三联组(69例);四联组采用埃索美拉唑20 mg+克拉霉素缓释0.5 g+阿莫西林1.0 g+枸橼酸铋钾胶囊220 mg/d,三联组采用埃索美拉唑20 mg+克拉霉素缓释片0.5 g+阿莫西林1.0 g/d,7 d为1疗程。②采用14C-UBT检测Hp根除率。③按ITT和PP分析,计算成本-效果比(C/E)及增量成本-效果比(△C/△E)。结果:四联组Hp根除率为88.71%,三联组Hp根除率为73.02%,两组比较差异有统计学意义(P<0.05)。四联组和三联组成本-效果比分别为4.15和4.82,含铋剂四联相对于标准三联方案增量成本-效果比为1.02。结论:Hp根除率含铋剂四联方案较标准三联方案高,可推荐为经济、高效的一线治疗方案。

关键词：螺杆菌,幽门/药物疗法药物疗法,联合克拉霉素/治疗应用阿莫西林/治疗应用奥美拉唑/治疗应用钾/治疗应用铋/治疗应用柠檬酸盐类/治疗应用消化性溃疡/药物疗法治疗结果费用效益分析

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埃索美拉唑在治疗HP相关性胃炎、十二指肠溃疡中的价值

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陕西医学杂志 2008年第10期37卷 1377-1378页

作者：张雪丽王亚宁惠莉西安市第一医院消化科西安710002

目的:探索埃索美拉唑为主治疗幽门螺旋杆菌(HP)相关的慢性胃炎及十二指肠溃疡的治疗效果。方法:66例HP阳性的慢性胃炎、十二指肠溃疡患者给与埃索美拉唑+克拉霉素+阿莫西林3联治疗1周,停药4周后复查胃镜及C14-HP。结果:HP根除率94%,溃... 详细信息

目的:探索埃索美拉唑为主治疗幽门螺旋杆菌(HP)相关的慢性胃炎及十二指肠溃疡的治疗效果。方法:66例HP阳性的慢性胃炎、十二指肠溃疡患者给与埃索美拉唑+克拉霉素+阿莫西林3联治疗1周,停药4周后复查胃镜及C14-HP。结果:HP根除率94%,溃疡愈合率85%,糜烂修复率100%,临床症状改善率100%。结论:以埃索美拉唑为主的3联1周疗法根除HP效果明显,根除HP后胃粘膜糜烂修复、溃疡愈合。

关键词：胃炎/药物疗法十二指肠溃疡/药物疗法克拉霉素/治疗应用阿莫西林/治疗应用 @埃索美拉唑

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低剂量新三联疗法治疗HP相关性溃疡疗效观察

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陕西医学杂志 2001年第11期30卷 681-682页

作者：蹇珍课陕西省商业医院内科西安710001

对象及方法50例均为我院近年来门诊或住院病人,均因上腹疼痛或黑便而行胃镜检查证实为消化性溃疡患者.其中胃溃疡10例,十二指肠球部溃疡40例.并均在胃窦大弯侧及小弯侧各取活检1块,送病理染色,证实为HP阳性.以上患者随机分为两组:A组20... 详细信息

对象及方法50例均为我院近年来门诊或住院病人,均因上腹疼痛或黑便而行胃镜检查证实为消化性溃疡患者.其中胃溃疡10例,十二指肠球部溃疡40例.并均在胃窦大弯侧及小弯侧各取活检1块,送病理染色,证实为HP阳性.以上患者随机分为两组:A组20例,采用低剂量新三联疗法:洛赛克20mg,每日2次;阿莫西林1.0g,每日2次;甲硝唑0.4g,每日2次,疗程为1周.B组30例,采用标准三联疗法:洛赛克20mg,每日1次,连用4周;阿莫西林0.5g,每日3次,甲硝唑0.4g,每日3次,疗程2周.观察两组服药后上腹痛的消失情况及不良反应,停药4周后复查胃镜,观察溃疡的愈合情况,再次取活检做病理染色,观察HP的阴转情况.

关键词：消化性溃疡/药物疗法洛赛克/治疗应用阿莫西林/治疗应用甲硝唑/治疗应用

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中西医结合治疗消化性溃疡32例

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陕西中医 2005年第1期26卷 25-26页

作者：马存忠王进文宁夏回族自治区中卫市中医院 751700 宁夏回族自治区中卫市卫生局

目的 :观察舒肝理气、缓急止痛、活血化瘀、健脾生肌类中药 ,配合抗生素治疗胃及十二指肠球部溃疡的临床疗效。方法 :采用加味芍药甘草汤 (白芍、甘草、莪术 )随证加味 ,合用安比先、甲硝唑口服治疗观察 60例。并设对照组对比。结果 :... 详细信息

目的 :观察舒肝理气、缓急止痛、活血化瘀、健脾生肌类中药 ,配合抗生素治疗胃及十二指肠球部溃疡的临床疗效。方法 :采用加味芍药甘草汤 (白芍、甘草、莪术 )随证加味 ,合用安比先、甲硝唑口服治疗观察 60例。并设对照组对比。结果 :两组溃疡完全愈合率、总愈合率、复发率比较有显著差异 ( P<0 .0 1 ) ,治疗组明显优于对照组。提示 :本方法有 :杀灭、抑制幽门螺旋杆菌、消肿止痛、祛瘀生肌等作用。

关键词：消化性溃疡/中西医结合疗法阿莫西林/治疗应用舒肝解郁剂/治疗应用

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Atrophy and intestinal metaplasia one year after cure of H-pylori infection:: A prospective, randomized study

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GASTROENTEROLOGY 2000年第1期119卷 7-14页

作者： Sung, JJY Lin, SR Ching, JYL Zhou, LY To, KF Wang, RT Leung, WK Ng, EKW Lau, JYW Lee, YT Yeung, CK Chao, W Chung, SCS Chinese Univ Hong Kong Endoscopy Ctr Hong Kong Hong Kong Peoples R China Beijing Med Univ Dept Gastroenterol Beijing Peoples R China

Background & Aims: Helicobacter pylori-infected gastric mucosa evolves through stages of chronic gastritis, intestinal metaplasia (IM), glandular atrophy (GA), and dysplasia before carcinoma develops. We studied if H. pylori eradication would alter the course of premalignant histologic changes in the stomach. Methods: Volunteers from the Yantai County in China underwent upper endoscopy with biopsy specimens obtained from the antrum and corpus. H. pylori-infected subjects were randomized to receive either a 1-week course of omeprazole, amoxicillin, and clarithromycin (OAC) or placebo. At 1 year, endoscopies with biopsies were repeated. Results: A total of 587 H. pylori-infected subjects were randomized to OAC (n = 295) and placebo (n = 292), At 1 year, H, pylori was eradicated in 226 subjects assigned to OAC. In the placebo group, 245 patients remained H. pylori infected. Analysis of paired samples obtained from the same patients showed that acute and chronic gastritis decreased in both the antrum and corpus after H. pylori eradication (P < 0.001) and activity of IM decreased in antrum (P = 0.014). In the H, pylori-infected group, antral biopsy specimens had more pronounced acute gastritis (P = 0.01), whereas corpus specimens showed increased acute and chronic gastritis (P < 0.001) and a marginal increase in GA (P = 0.052). When histologic changes were compared between the 2 groups, decrease in acute and chronic gastritis was more frequent after H. pylori eradication (P < 0.001) but changes in IM were similar. In the H. pylori-infected group, increase in GB was seen in the corpus IP = 0.01). Conclusions: At 1 year, H. pylori eradication is beneficial in preventing progression of pathologic changes of the gastric mucosa.

关键词：阿莫西林/治疗应用抗菌药/治疗应用萎缩克拉霉素/治疗应用内窥镜检查胃黏膜/微生物学胃黏膜/病理学胃镜检查螺杆菌感染/病理学幽门螺杆菌肠/病理学化生奥美拉唑/治疗应用青霉素类/治疗应用前瞻性研究成年人老年人女(雌)性人类男(雄)性中年人

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Treatment of Helicobacter pylori in patients with duodenal ulcer hemorrhage -: A long-term randomized, controlled study

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AMERICAN JOURNAL OF GASTROENTEROLOGY 2000年第9期95卷 2225-2232页

作者： Lai, KC Hui, WM Wong, WM Wong, BCY Hu, WHC Ching, CK Lam, SK Univ Hong Kong Queen Mary Hosp Dept Med Div Gastroenterol Hong Kong Hong Kong Peoples R China

OBJECTIVE: Eradication of Helicobacter pylori (H. pylori) in patients with uncomplicated duodenal ulcers prevents longterm recurrence of ulcers. We aimed to study whether treatment of H. pylori prevents the long-term recurrence of duodenal ulcer hemorrhage. METHODS: Patients with duodenal ulcer bleeding and confirmed H. pylori infection were recruited. A total of 120 patients were randomly assigned to triple therapy (DeNoltab 120 mg, amoxycillin 500 mg, and metronidazole 300 mg four times daily) or DeNoltab 120 mg four times daily alone. No maintenance therapy was given during the follow-up period. The endpoints were the cumulative rates of symptomatic and bleeding duodenal ulcer recurrences. RESULTS: Of the patients receiving the triple regimen, 85.1% had H. pylori eradicated as compared to 2.0% of patients receiving DeNoltab (p < 0.05). More patients in the DeNoltab group than those in the Triple group had recurrence of ulcer bleeding, but this did not reach statistical significance (12/60 vs 6/60, p = 0.20). Logistic regression analysis on clinical, personal, and endoscopic characteristics identified persistent H. pylori infection as the only independent predictor of recurrence of duodenal ulcer bleeding. CONCLUSIONS: Treatment of H. pylori alone with the present bismuth-based triple therapy in patients with duodenal ulcer hemorrhage did not result in significant reduction in further bleeding episodes, although a trend was seen for the group that was given triple therapy. On the other hand, posttreatment H. pylori status was found to be an independent predictor of bleeding recurrence. (Am J Gastroenterol 2000;95:2225-2232. (C) 2000 by Am. Cell. of Gastroenterology).

关键词：阿莫西林/治疗应用抗酸剂/治疗应用抗菌药/治疗应用铋药物疗法联合/治疗应用十二指肠溃疡/并发症十二指肠溃疡/药物疗法十二指肠溃疡/病理学内窥镜检查消化系统随访研究螺杆菌感染/并发症螺杆菌感染/药物疗法螺杆菌感染/病理学螺杆菌幽门/药物作用螺杆菌幽门/分离和提纯肠黏膜/微生物学肠黏膜/病理学甲硝唑/治疗应用消化性溃疡出血/药物疗法消化性溃疡出血/病因学消化性溃疡出血/病理学预后复发/预防和控制青少年成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Is Helicobacter pylori eradication associated with gastroesophageal reflux disease?

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AMERICAN JOURNAL OF GASTROENTEROLOGY 2000年第4期95卷 914-920页

作者： Fallone, CA Barkun, AN Friedman, G Mayrand, S Loo, V Beech, R Best, L Joseph, L McGill Univ Ctr Hlth Div Gastroenterol Montreal PQ Canada McGill Univ Ctr Hlth Div Epidemiol Montreal PQ Canada McGill Univ Ctr Hlth Div Biostat Montreal PQ Canada McGill Univ Inst Parasitol Montreal PQ Canada Dalhousie Univ Queen Elizabeth II Hlth Sci Ctr Halifax NS Canada

OBJECTIVES: A recent report has suggested an association between Helicobacter pylori eradication and the development of gastroesophageal reflux disease (GERD). We therefore assessed the incidence of GERD among comparable patients having undergone successful versus failed H. pylori eradication in a controlled trial. We also compared the H. pylori strains in the subjects that developed GERD to those that did not. METHODS: Patients with a history of proven duodenal ulcer and H. pylori infection were randomised into a H. pylori eradication study. Patients subsequently underwent gastroscopy with gastric biopsies every 3 months for 1 yr. At each visit, the presence of GERD symptoms and endoscopic esophagitis were noted, and the incidence of these variables among patients in whom H, pylori eradication was successful was compared to those in whom it was not. In a subgroup, the presence of the cagA, cagE, and vacA genotypes and of cagA antibodies were determined. RESULTS: Of 98 patients randomized into this study, 11 dropped out before determination of H. pylori eradication, leaving 87 patients with analyzable results. H, pylori eradication was successful in 63 (72%). By the end of the follow-up period, patients with GERD symptoms or endoscopic esophagitis were more prevalent in the successful than in the failed eradication group (37% [95% CI: 25-50%] vs 13% [95% CI: 3-32%], p = 0.04, 95% CI for the difference. 6-42%), as were patients with GERD symptoms alone (29% [95% CI: 18-41%] vs 8% [95% CI: 1-27%], p = 0.04, 95% CI for the difference: 4-36%) or esophagitis alone (21% [95% CI: 12-33%] vs 4% [95% CI: 0-21%], p = 0.10, 95% CI for the difference: 4-29%, respectively). Multivariate analysis revealed no significant association between the incidence of symptoms or esophagitis and age, Sender, Quetelet index, caffeine or alcohol intake, smoking, weight change, or the presence of a hiatus hernia. There were also no differences in the prevalence of H. pylori genotypes from patie

关键词：阿莫西林/治疗应用抗溃疡病药/治疗应用铋/治疗应用双盲法药物疗法联合十二指肠溃疡/药物疗法十二指肠溃疡/微生物学食管炎消化性/病因学食管炎消化性/微生物学随访研究胃食管反流/病因学胃食管反流/微生物学胃镜检查基因型螺杆菌感染/药物疗法螺杆菌感染/微生物学螺杆菌幽门/药物作用螺杆菌幽门/遗传学甲硝唑/治疗应用治疗失败青少年成年人老年人女(雌)性人类男(雄)性中年人

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Streptococcus pneumoniae pneumonia in mice:: Optimal amoxicillin dosing predicted from a pharmacokinetic pharmacodynamic model

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JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS 1999年第3期291卷 1086-1092页

作者： Moine, P Mazoit, JX Univ Paris 11 Fac Med Kremlin Bicetre CHU Bicetre Dept Anesthesie ReanimatServ & Lab Anesthesie F-94275 Le Kremlin Bicetre France Ctr Hosp Univ Bichat Claude Bernard Contrat Rech Inst Natl Sante & Rech Med CRI 4U 00 Paris France

In an attempt to better understand the interaction of amoxicillin with Streptococcus pneumoniae in the lung, and to determine the parameters of therapeutic efficacy of the antimicrobial agent amoxicillin, we used a pharmacokinetic-pharmacodynamic model to describe the overall dose-effect relationship of amoxicillin against 12 strains of S. pneumoniae with penicillin minimum inhibitory concentrations ranging from <0.01 to 16 mu g/ml in a neutropenic murine pneumonia model. We were able to correlate amoxicillin dosing, pharmacokinetics, and the temporal changes in bacterial count in lung. Moreover, survival rates measured in one strain at different dosing were significantly related to the number of bacteria in lung calculated from the pharmacokinetic-pharmacodynamic model. Disappearance of amoxicillin from the effect compartment appeared to be very slow and the rate constant (k(e0)) governing this process was significantly different between strains, ranging from 0.00131 to 0.03945 h(-1). These findings have two major implications: 1) after a single dose of amoxicillin, bacterial counts in lung rapidly decreased and the bacterial growth remained suppressed during a long period of time after cessation of exposure of microorganisms to amoxicillin;and 2) the duration of bacterial growth suppression was related to the intrinsic properties of S. pneumoniae strains rather than to host environment because k(e0) was significantly different between strains. These two premises clearly demonstrate that bacterial growth suppression is related to an in vivo postantibiotic effect. Furthermore, we have shown that the major determinant of amoxicillin in vivo bactericidal activity and therapeutic efficacy appeared to be the dose of amoxicillin because amoxicillin exhibits a rapid dose-dependent killing regardless of the S. pneumoniae strain. Our findings may have implications for the clinical use of amoxicillin. In view of our results, the guidance to increase the amoxicillin-loading d

关键词：阿莫西林/投药和剂量阿莫西林/药代动力学阿莫西林/治疗应用剂量效应关系药物肺/代谢肺/微生物学微生物敏感性试验模型生物学中性粒细胞减少/并发症青霉素类/投药和剂量青霉素类/药代动力学青霉素类/治疗应用肺炎球菌感染/药物疗法肺炎球菌感染/代谢链球菌肺炎/药物作用存活率分析动物小鼠

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Comparative in vitro activity of telithromycin (HMR 3647), three macrolides, amoxycillin, cefdinir and levofloxacin against Gram-positive clinical isolates in Japan

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JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY 2000年第5期46卷 797-802页

作者： Okamoto, H Miyazaki, S Tateda, K Ishii, Y Yamaguchi, K Toho Univ Sch Med Dept Microbiol Ota Ku Tokyo Japan

The in vitro activities (MIC and MBC) of telithromycin (HMR 3647) against clinical isolates in Japan were investigated in comparison with those of erythromycin A, clarithromycin, azithromycin, amoxyciliin, cefdinir and levofloxacin, Telithromycin was more potent than the reference compounds against erythromycin A-susceptible or resistant Streptococcus pneumoniae isolates possessing either mef (mefA or mefE) genes or the ermB gene, Against erythromycin A-susceptible or inducibly resistant Staphylococcus aureus and erythromycin A-susceptible and intermediate Enterococcus faecalis, telithromycin was highly active.

关键词：阿莫西林/药理学阿莫西林/治疗应用抗菌药/药理学抗菌药/治疗应用头孢菌素类/药理学头孢菌素类/治疗应用社区获得性感染/药物疗法社区获得性感染/免疫学抗药性微生物/免疫学红霉素/治疗应用革兰氏阳性菌/药物作用革兰氏阳性菌/免疫学革兰氏阳性菌/分离和提纯日本酮内酯类抗生素大环内酯类微生物敏感性试验/方法氧氟沙星/药理学氧氟沙星/治疗应用青霉素类/药理学青霉素类/治疗应用呼吸道感染/药物疗法呼吸道感染/免疫学金黄色葡萄球菌/药物作用金黄色葡萄球菌/免疫学人类

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Cost saving of 5-day therapy with cefpodoxime proxetil versus standard 10-day beta-lactam therapy for recurrent pharyngotonsillitis in adults - A prospective general practice study

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PHARMACOECONOMICS 1996年第3期10卷 239-250页

作者： Pelc, A Portier, H Gehanno, P Fiessinger, S Ichou, F IMS INT HLTH ECON DEPTMONTROUGEFRANCE

A prospective economic evaluation was undertaken as part of a randomised clinical trial conducted in French general practice. Its aim was to compare the costs and therapeutic outcomes of a 5-day course of cefpodoxime proxetil 100mg twice daily with 10-day courses of phenoxymethylpenicillin (penicillin V) 1 MIU 3 times daily and amoxicillin-clavulanic acid 500/125mg 3 times daily for the treatment of recurrent pharyngotonsillitis in 575 adults. Over the 6-month study period, the total cost to society per patient treated with cefpodoxime proxetil was 123 French francs (FF;1993 values) lower than that for patients treated with phenoxymethylpenicillin and FF227 lower than that for patients treated with amoxicillin-clavulanic acid. This cost saving was primarily attributable to a lower initial drug acquisition cost, and a reduction in the cost associated with lost productivity and general practitioner consultations. Furthermore, as a consequence of a lower relapse rate, the cost-saving ratio for cefpodoxime proxetil, expressed as FF per month free of recurrence, was FF50 less than for phenoxymethylpenicillin and FF60 less than for amoxicillin-clavulanic acid. Thus, a 5-day course of cefpodoxime proxetil is likely to be less costly for treatment of pharyngotonsillitis in the general practice setting than standard 10-day courses of phenoxymethylpenicillin and amoxicillin-clavulanic acid.

关键词：阿莫西林/治疗应用抗菌药/经济学抗菌药/治疗应用头孢唑肟/类似物和衍生物头孢唑肟/经济学头孢唑肟/治疗应用棒酸棒酸类/经济学棒酸类/治疗应用费用效益分析药物疗法联合/经济学药物疗法联合/治疗应用家庭医学法国青霉素Ⅴ/经济学青霉素Ⅴ/治疗应用咽炎/药物疗法咽炎/经济学药物前体/经济学药物前体/治疗应用复发扁桃体炎/药物疗法扁桃体炎/经济学治疗结果成年人人类

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