BACKGROUND AND AIMS:Although the role of H. pylori in peptic ulcer disease is no longer in dispute, certain aspects of eradication therapy in this condition have yet to be settled. Uncertainties still surround the relationship between Helicobacter pylori status and ulcer healing, the efficacy of eradication therapy in alleviating acute symptoms and healing ulcers, and the prognosis after eradication with respect to recurrence of symptoms, ulcers and complications. The present literature review, encompassing studies published up to October 1995, specifically addresses these issues.

RESULTS:Pooled data show that eradication therapy heals > or = 90% of duodenal ulcers and > or = 85% of gastric ulcers, while individual studies repeatedly confirm that it is more effective at healing ulcers than conventional treatment with anti-secretory drugs. Recent reports indicate that triple therapy regimens for 1 week, provided they include an anti-secretory drug, are sufficient to achieve high rates of healing and rapid symptom relief. A detailed analysis of the data, particularly those from studies reporting healing rates in relation to H. pylori status after eradication therapy, provides strong evidence that eradication of H. pylori produces ulcer healing. Follow-up studies show that ulcer recurrence and complications are rare after eradication treatment in patients with either gastric or duodenal ulcer disease. However, while ulcer symptoms are infrequent during follow-up, a proportion of patients appear to develop gastrooesophageal reflux after eradication.

CONCLUSIONS:H. pylori eradication is highly effective in promoting ulcer healing and preventing subsequent ulcer recurrence. These beneficial effects of eradication therapy are observed in patients with either gastric or duodenal ulcers which are associated with H. pylori infection.

译文

背景和目标 : 尽管幽门螺杆菌在消化性溃疡疾病中的作用不再存在争议,但在这种情况下根除治疗的某些方面尚未解决。幽门螺杆菌状态与溃疡愈合之间的关系,根除治疗在缓解急性症状和溃疡愈合方面的疗效以及根除后症状,溃疡和并发症复发的预后之间的不确定性仍然存在。目前的文献综述,包括1995年10月发表的研究,专门解决了这些问题。结果: 汇总数据显示,根除疗法可以治愈十二指肠溃疡的90% 和胃溃疡的85%,虽然个别研究反复证实,它在治疗溃疡方面比传统的抗分泌药物治疗更有效。最近的报告表明,如果包括抗分泌药物,则三联疗法为期1周,足以实现高治愈率和快速缓解症状。对数据的详细分析,尤其是那些报道根除治疗后与幽门螺杆菌状态相关的治愈率的研究,提供了强有力的证据,证明根除幽门螺杆菌可产生溃疡愈合。随访研究表明,在胃或十二指肠溃疡疾病患者中,根除治疗后溃疡复发和并发症很少见。然而,尽管在随访期间溃疡症状很少出现,但根除后似乎有一部分患者出现胃食管反流。
结论 : 根除幽门螺杆菌在促进溃疡愈合和预防随后的溃疡复发方面非常有效。在与幽门螺杆菌感染相关的胃或十二指肠溃疡患者中观察到根除治疗的这些有益效果。

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