Different Genotypes Of Helicobacter Pylori Associate With Gastroduodenal Diseases And Influence On Triple Eradication Therapy

PART IThe Comparison of Esomeprazole Versus Omeprazole Triple Eradicationon Helicobacter Pylori Positive Duodenal UlcerObjective: to compare two different regimens of esomeprazole-based triple therapy versus omeprazole-based triple therapy for the eradication of Helicobacter pylori (H. pylori) infection and the efficacy on healing of duodenal ulcer, and also to assess the safety of esomeprazole-based triple therapy. Methods: This randomized, parallel-controlled study was conducted in eighty-one patients with H. pylori infection proven by both histology and rapid urease test and active duodenal ulcer were assigned to receive one of the two regimens: clarithromycin 500mg bid and amoxicillin 1000mg bid together with either esomeprazole 20mg bid (esomeprazole group) or omeprazole 20mg bid (omeprazole group) for 7 days, then treated the esomeprazole group with placebo for another three weeks, while the omeprazole group with omeprazole 20mg qd at the same time. The relief of the symptoms of epigastric pain, sour regurgitation and heart-burn were also evaluated before treatment, on the 1st, 2nd, 7th, 28th, 35th after the treatment. The eradication rates of H. pylori and the healing rates of duodenal ulcer were evaluated by the second endoscopy on the 28th day after completion of triple therapy. Results: seventy- eight patients completed the trial. Three patients dropped out. The symptoms of esomeprazole group relieved rapidly at the beginning of the treatment than that of omeprazole group (P<0.05), but no statistically difference after one week treatment. The eradication rates of H. pylori in esomeprazole group and omeprazole group were 87.5% and 81.6%, respectively. There was no statistically significant difference between the two groups (P>0.05). The ulcer healing rates in esomeprazole group and omeprazole group were 92.5% and 86.8%, respectively. There was no statistically significant difference between the two groups P>0.05) also. No obvious adverse events took place in both groups. Conclusion: both regimens can improve the symptoms of duodenal ulcer patients effectively, and may eradicate H. pylori, and heal the ulcers, there is no necessary for further treatment with PPI in esomeprazole group, and esomeprazole for short term using is safe.