EXPERIENCE OF HELICOBACTER PYLORI ERADICATION THERAPY IN PATIENTS WITH STOMACH ULCER DUODENUM
DOI:
https://doi.org/10.11603/1811-2471.2018.v0.i3.9314Keywords:
peptic ulcer, Helicobacter pylori, treatmentAbstract
According to research and epidemiological data, more than half of the planet's population is infected by this microorganism. HB infection is often asymptomatic, only part of the infected (10–15 %) develop symptoms of chronic gastritis, VHS and BH of the duodenum, stomach cancer, and the pathogenetic condition for elimination of HP is antigelibobacter therapy (AGBT), which is the primary prophylaxis of gastric cancer.
The aim of the study – to determine the efficacy of a ten-hour sequencer of AGBT consisting of proton pump inhibitors (PPIs), clarithromycin, amoxicillin in classical doses and PPIs, clarithromycin, amoxicillin and De-Nolo in peptic ulcers of the duodenum associated with H. pylori, in smaller doses and 4 times the admission and conduct a comparative evaluation.
Material and Methods. Under our supervision, there were 25 patients aged 18 to 64 years old with HP (+) ulcer of the duodenum. All patients underwent endoscopic examination for ulcer diagnosis, histological examination of the mucosal biopsy (CO) of the astral stomach and diagnosis of HP by the immune enzyme method. 1st group (n = 10) received the standard triple therapy recommended by Maastricht IV: PPI + clarithromycin 500 mg twice daily + amoxicillin 1000 mg twice daily for 10 days; 2nd group (n = 15) PPI + clarithromycin in a dose of 250 mg 4 times a day + amoxicillin in a dose of 500 mg 4 times a day for 10 days; bismuth subcitrate colloidal in a dose of 120 mg 4 times a day.
Results. In all patients after treatment, there was a scarring of the ulcers, a significant decrease in gastritis, which was manifested as minor hyperemia in half of the patients in the first group and in the two patients in the second group. Histological examination of the biopsy of the gastric mucosa confirmed the presence of part of the patients with HP infection. The control study on HP was performed after 6 months using the immune enzyme method. In patients, the control group HP was found in 4 (40 %) patients, in the main – in 3 (20 %).
Conclusion. The use of standard triple therapy PPI + clarithromycin 500 mg twice a day + amoxicillin in a dose of 1000 mg twice daily for 10 days does not provide complete eradication of HP and does not eliminate the histological picture of gastritis. Admission of colloidal bismuth, antibiotics amoxicillin and clarithromycin at a lower dose with more frequent ingestion (4 times a day) provided better sanitation for HP infection and histological structure of the mucous membrane of the stomach, apparently due to a more permanent prolonged antimicrobial action, and did not increase the cost of treatment , which needs to be proved in further research.
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