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目的：本文报道克拉霉素与甲硝唑及兰索拉唑联合应用治疗ＨＰ阳性的十二指肠溃疡。方法：５９例符合条件的病人随机分成两个治疗组，其中３０例口服充拉霉素２５０ｍｇ，甲硝唑４００ｍｇ，兰索拉唑３０ｍｇ。另一组２９例口服克拉霉素５００ｍｇ，甲硝唑４００ｍｇ．兰索拉唑３０ｍｇ，用法均为每日２次，疗程１周，继而口服兰索拉唑３０ｍｇ，每日１次，共１周。疗程结束后１个月复查胃镜。结果：克拉霉素１０００ｍｇ组ＨＰ根除率及溃疡愈合率分别为９３．１％及８９．７％，稍高于克拉霉素５００ｍｇ组的７６．７％及８０．０％，但差异无显著性（Ｐ＞０．０５）。体外检测。克拉霉素ＨＰ耐药发生率仅４．８％，而甲硝唑ＨＰ耐药发生率则达３３．３％，且甲硝唑耐药对ＨＰ根除率有较大影响。两组病人副反应总发生率为１５．３％，克拉霉素两个剂量组间副反应发生率无明显差别，未发现严重副反应。病人依从性良好。结论：克拉霉素与甲硝唑及兰索拉唑合用１周疗法有较理想的溃疡愈合率与ＨＰ根除率；克拉霉素用量以每日１０００ｍｇ为佳。
Objective: This article reports the clarithromycin and metronidazole and lansoprazole combined treatment of HP-positive duodenal ulcer. Methods: Fifty-nine eligible patients were randomly divided into two treatment groups, of which 30 cases were given oral hygromycin 250mg, metronidazole 400mg, lansoprazole 30mg. Another group of 29 cases of oral clarithromycin 500mg, metronidazole 400mg. Lansoprazole 30mg, usage are 2 times daily, course of treatment for 1 week, followed by oral administration of Lansoprazole 30mg, 1 day, a total of 1 week. Gastroscope was reviewed one month after the end of treatment. Results: The eradication rate and ulcer healing rate of clarithromycin 1000mg group were 93.1% and 89.7%, respectively, slightly higher than those of clarithromycin 500mg group 76.7% and 80.0%, but the difference was not significant (P> 0.05). In vitro testing. The incidence of clarithromycin HP resistance was only 4.8%, while the incidence of HP metronidazole HP reached 33.3%, and metronidazole resistance on HP eradication rate has a greater impact. The overall incidence of side effects in both groups was 15.3%. There was no significant difference in the incidence of side effects between the two doses of clarithromycin, and no serious side effects were found. Patient compliance is good. Conclusion: The combination of clarithromycin with metronidazole and lansoprazole for one week has better ulcer healing rate and HP eradication rate. The best dosage of clarithromycin is 1000 mg per day.