Objective To investigate the best medication for treatment of peptic ulcer in Helicobacter pylori (HP) positive elderly patients.Methods 100 HP positive patients with peptic ulcer aged ＞60 were divided into two groups according to the random number table.The control group (50 patients) received omeprazole of 20 mg,amoxicillin of 1,000 mg,and metronidazole of 400 mg twice daily for one week and then 20 mg omeprazole alone once daily for one week.The study group (50 patients) received rabeprazole of 10mg,amoxicillin of 1,000 mg,and metronidazole of 400 mg twice daily for one week and then 10mg rabeprazole alone once daily for one week.Results The rate of ulcer healing was 92.00％ (46/50) in the study group and 78.00％ (39/50) in the control group; and the total effectiveness rate was 98.00％ (49/50) and 94.00％ (47/50),respectively.The rate of ulcer healing was significantly higher in the study group than in the control group (x 2=3.843,P＜0.05),while there was no significant difference in the total effectiveness rate (x 2=1.042,P＞0.05).The rate of HP eradication rate was significantly higher in the study group than in the control group [94.00％ (47/50) vs.82.00％ (41/50),x 2=3.409,P＜0.05].Conclusions Rabeprazole-based triple therapy is better than omeprazole-based therapy in acceleration of ulcer healing and in complete eradication of H.pylori infection.It is an ideal therapy for peptic ulcer.%目的 探讨治疗幽门螺杆菌(Helicobacter pylori,HP)阳性的老年消化性溃疡的最佳用药方法.方法 采用随机数字表法将HP阳性且年龄＞60岁的消化性溃疡患者100例分为对照组和观察组,各50例.对照组口服奥美拉唑20 mg/次、阿莫西林1000mg/次及甲硝唑400 mg/次,均每日2次,连用1周后单服奥美拉唑,20 mg/次,每日1次,连服1周.观察组口服雷贝拉唑10 mg/次、阿莫西林1000 mg/次及甲硝唑400 mg/次,均每日2次,连用1周后单服雷贝拉唑10 mg/次,每日1次,连服1周.结果 观察组愈合率为92.00％(46/50),总有效率为98.00％(49/50)；对照组愈合率为78.00％(39/50),总有效率为94.00％(47/50)；观察组愈合率明显高于对照组(x2=3.843,P＜0.05),而总有效率差异无统计学意义(x2=1.042,P＞0.05).观察组HP根除率为94.00％(47/50),明显高于对照组的82.00％(41/50),差异有统计学意义(x 2=3.409,P＜0.05).结论 雷贝拉唑三联疗法较奥美拉唑三联疗法更能促进患者溃疡愈合、彻底根除幽门螺旋杆菌感染,是治疗消化性溃疡的理想用药方法.
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