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目的：观察奥美拉唑与铋剂为中心三联合用对幽门螺杆菌（Ｈｐ）的根除效果及安全性。方法：胃粘膜Ｈｐ阳性的十二指肠溃疡患者随机分为三联组（枸橼酸铋钾１２０ｍｇ、阿莫西林２５０ｍｇ，甲硝唑２００ｍｇ，各每日４次共２周，后继服枸橼酸铋钾２４０ｍｇ，每日２次，服２周）、四联（三联基础上加奥美拉唑２０ｍｇ，２次／日，服四药１周）组，后继服奥美拉唑２０ｍｇ，每日１次，服３周，Ｈｐ根除和溃疡愈合均以停药４周后胃镜复查为准。结果：四联组Ｈｐ根除率９１％（３８／４２）和溃疡愈合率９５％（４０／４２）高于三联组的８０％（２０／２５）及９２％（２３／２５），但无统计学差异。四联组副作用（１７％）少于三联组（２８％），差别无显著性。结论：四联疗法可获得高Ｈｐ根除率，不良反应少，疗程短，值得进一步试用。
OBJECTIVE: To observe the eradication effect and safety of omeprazole and bismuth in combination with Helicobacter pylori (Hp). Methods: Gastric mucosal Hp-positive duodenal ulcer patients were randomly divided into triple group (bismuth potassium citrate 120mg, amoxicillin 250mg, metronidazole 200mg, 4 times a day for 2 weeks, followed by citric acid Bismuth potassium 240mg, 2 times a day for 2 weeks), quadruple (triple on the basis of plus omeprazole 20mg, 2 times / day, taking four drugs for 1 week) group, followed by omeprazole 20mg, daily 1 times for 3 weeks, Hp eradication and ulcer healing were discontinued 4 weeks after gastroscopy review shall prevail. Results: The Hp eradication rate was 91% (38/42) and the ulcer healing rate was 95% (40/42) in the quadruple group compared with 80% (20/25) and 92% (23/25) in the triad group, but no statistics Differences The quadruple group had fewer side effects (17%) than the triple group (28%), with no significant difference. Conclusion: The quadruple therapy can achieve high Hp eradication rate, less adverse reactions, short course of treatment, it is worth further trial.