Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia
Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia
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DOI：
10.1056/nejm199812243392602
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发表时间：
1998-12-24
影响因子：
158.5
通讯作者：
Junghard, O
中科院分区：
文献类型：
--
作者：
Blum, AL;Talley, NJ;Junghard, O
幽门螺杆菌感染治疗是否能缓解非溃疡性或功能性消化不良患者的症状尚不确定。幽门螺杆菌感染和消化不良症状（中度至非常严重的疼痛和不适集中在上腹部）。如果患者有消化性溃疡病或胃食管反流病病史，并且上消化道内窥镜检查结果异常，则将其排除。患者被随机分配到20 mg奥美拉唑每日两次、1000 mg阿莫西林每日两次和500 mg克拉霉素每日两次或奥美拉唑单药治疗7天，然后随访1年。治疗成功被定义为没有消化不良症状或存在的最小症状的任何7天前的12个月vision.Results结果20的348例患者被排除后，随机分组，因为他们没有感染H。pylori，未接受治疗，或无可用数据。对于其余328例患者（每组164例），27.4%的患者接受奥美拉唑和抗生素治疗，20.7%的患者接受奥美拉唑单药治疗（P = 0.17;组间绝对差异为6.7%; 95%置信区间为-2.6至16.0）。12个月后，奥美拉唑和抗生素组的胃炎愈合率为75.0%，奥美拉唑组为3.0%（P
Background It is uncertain whether treatment of Helicobacter pylori infection relieves symptoms in patients with nonulcer, or functional, dyspepsia.Methods We conducted a double-blind, multicenter trial of patients with H. pylori infection and dyspeptic symptoms (moderate-to-very-severe pain and discomfort centered in the upper abdomen). Patients were excluded if they had a history of peptic ulcer disease or gastroesophageal reflux disease and had abnormal findings on upper endoscopy. Patients were randomly assigned to seven days of treatment with 20 mg of omeprazole twice daily, 1000 mg of amoxicillin twice daily, and 500 mg of clarithromycin twice daily or with omeprazole alone and then followed up for one year. Treatment success was defined as the absence of dyspeptic symptoms or the presence of minimal symptoms on any of the 7 days preceding the 12-month visit.Results Twenty of the 348 patients were excluded after randomization because they were not infected with H. pylori, were not treated, or had no data available. For the remaining 328 patients (164 in each group), treatment was successful for 27.4 percent of those assigned to receive omeprazole and antibiotics and 20.7 percent of those assigned to receive omeprazole alone (P = 0.17; absolute difference between groups, 6.7 percent; 95 percent confidence interval, -2.6 to 16.0). After 12 months, gastritis had healed in 75.0 percent of the patients in the group given omeprazole and antibiotics and in 3.0 percent of the patients in the omeprazole group (P