Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia
Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia
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DOI：
10.1056/nejm199812243392601
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发表时间：
1998-12-24
影响因子：
158.5
通讯作者：
Hilditch, T
中科院分区：
文献类型：
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作者：
McColl, K;Murray, L;Hilditch, T
背景根除幽门螺杆菌感染对胃溃疡或十二指肠溃疡患者有益。方法我们进行了一项随机、安慰剂对照试验，比较奥美拉唑20 mg，每日2次，阿莫西林500 mg，每日3次，治疗2周的疗效（在对青霉素过敏的患者中，用500 mg四环素每日三次代替阿莫西林），甲硝唑400 mg，每日3次（160例），奥美拉唑158例（158例）。幽门螺杆菌感染，但上消化道内窥镜检查无溃疡病证据。用格拉斯哥消化不良严重程度评分评估症状，症状缓解定义为前6个月内评分为0或1（最高评分为20）。一年后，患者进行评估，以确定频率的解决symptoms.Results治疗完成后一个月，132/150例（88%）的组中分配到接受奥美拉唑和抗生素的H。幽门螺杆菌，而在152人中有7人（5%）被分配接受奥美拉唑单独治疗。一年后，奥美拉唑联合抗生素组154例患者中有33例（21%）消化不良症状缓解，而奥美拉唑单药组154例患者中有11例（7%）消化不良症状缓解（差异的95%置信区间为7%-22%; P
Background The eradication of Helicobacter pylori infection is beneficial in patients with gastric or duodenal ulcers. The value of eradicating the infection in patients with dyspepsia and no evidence of ulcer disease is not known.Methods We performed a randomized, placebo-controlled trial comparing the efficacy of treatment for two weeks with 20 mg of omeprazole orally twice daily, 500 mg of amoxicillin three times daily (with 500 mg of tetracycline three times daily substituted for amoxicillin in patients allergic to penicillin), and 400 mg of metronidazole three times daily (160 patients) with that of omeprazole alone (158 patients) for resolving symptoms of dyspepsia in patients with H. pylori infection but no evidence of ulcer disease on upper gastrointestinal endoscopy. Symptoms were assessed with the Glasgow Dyspepsia Severity Score, with resolution of symptoms defined as a score of 0 or 1 in the preceding six months (maximal score, 20). One year later the patients were assessed to determine the frequency of the resolution of symptoms.Results One month after the completion of treatment, 132 of 150 patients (88 percent) in the group assigned to receive omeprazole and antibiotics had a negative test for H. pylori, as compared with 7 of 152 (5 percent) in the group assigned to receive omeprazole alone. One year later, dyspepsia had resolved in 33 of 154 patients (21 percent) in the group given omeprazole and antibiotics, as compared with 11 of 154 (7 percent) in the group given omeprazole alone (95 percent confidence interval for the difference, 7 to 22 percent; P