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Objective To explore the clinical efficacy of different course of colloidal bismuth pectin quadruple therapy for Helicobacter pylori (Hp) eradication in patients with peptic ulcer (PU) and the condition of digestive tract symptom improvement by a single-center,prospective,random-control study,and to provide theoretic evidence for clinicians on the selection of the schedule upon unti-PU Hp infection.Methods 90 active stage PU initial treated patients with Hp infection diagnosed by gastroscope were enrolled randomly.The patients were given oral unti-Hp treatment including rabeprazole sodium (20mg,2/day),clarithromycin (0.5 g,2/day),amoxicillin (1 g,2/day) and colloidal bismuth subcitrate (0.6g,2/day),and were divided into three groups with different course of treatment randomly acconding to the digital table:A group (7 days),B group (10 days) and C group (14 days),each group including 30 cases.The condition of digestive symptom improvement and adverse effect were recorded during treatment.After the quadruple therapy,and at least 4 weeks without using proton pump inhibitor (PPI) and antibiotics,the outcome of Hp eradication was evaluated by 14C carbamide breath test (14C-UBT).The difference of Hp eradication among the three groups was analyzed.The clinical efficacy of different course was evaluated and the cost/effect was calculated.Results The Hp eradication rates of the A group,B group and C group were 46.67％,73.33 ％ and 76.67％,respectively,the differences was statistically significant (x2 =7.184,P =0.028).After treatment,the scores of the digestive symptom of the three groups were lower than before treatment (A group:t =3.272,P =0.038;B group:t =6.424,P ＜ 0.001;C group:t =8.086,P ＜ 0.001),and the scores of the B group and C group were lower than A group (F =3.110,P =0.028),while the three groups showed no obvious difference in the incidence of adverse effects(x2 =0.274,P =0.872).The C/E of the A group,B group and C group were 4.7,4.3 and 5.7,respectively.Conclusion The 10-day and 14-day course of colloidal bismuth pectin quadruple therapy including rabeprazole sodium,clarithromycin,amoxicillin and colloidal bismuth subcitrate demonstrated better clinical efficacy of unti-PU Hp infection than the 7-day treatment,with obvious improvement of digestive symptom,and the 10-day quadruple therapy has the best economical advantage.
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0.05 ) between two groups. The side effects were 7.7 % and 13.3 % in treatment group and control group, respectively. CONCLUSION: The combination of CLA+CBS+Met for 1 wk is an effective and safe treatment for eradication of HP infection with recurrent abdominal in children.
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Objective To compare the protective effect of colloidal bismuth subcitrate-1 (CBS-1, Lizudele), or colloidal bismuth subcitrate-2 (CBS-2, De-Nol) and sucralfate against gastric mucosal lesion and to investigate their mechanisms. Methods Gastric mucosal injury of rats was induced by ethanol, stress, aspirin and hydrochloric acid. Gastric ulcer was then induced by 50% acetic acid applied to the gastric tunica serosa. We observed the protective effects against gastric mucosal lesion and measured the injury index and the area of ulcer in each group. Statistical t test was used to compare the difference of each group. Results (1)CBS-1, CBS-2, and sucralfate had protective effect against lesions caused by ethanol, stress, aspirin and hydrochloric acid and could promote acetic acid-induced gastric ulcer healing. (2) The mechanisms of protective effect and ulcer healing promotion were that these drugs could increase gastric blood flow and increase activities of QR, GST and GR, and could also promote overexpression of bFGF mRNA and iNOS mRNA. Conclusion Gastric mucosal protective drugs, CBS and sucralfate had effect of resisting injury and promoting ulcer healing. The mechanisms were that they could increase gastric mucosal blood flow and the expression of bFGF mRNA and iNOS mRNA, and reduce oxygen free radical.
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We report an open trial study to determine the role of Helicobacter pylori (HP) in patients with non-ulcer dyspepsia (NUD) and to determine the effect of two drugs (colloidal bismuth subcitrate, CBS and cimetidine) on HP. Our study consisted of 48 patients, 30 received CBS two tablets twice daily and 18 received cimetidine 400 mg twice daily. The result of HP suppression detected by rapid urease test was 66.7% and 86.7% for CBS group after receiving the drug for 4 and 8 weeks respectively, for cimetidine only 11.1% urease test negative during the same period. Follow up urease test 19.2% of patients treated by CBS remained negative but none in the cimetidine group. AII patients felt better during treatment irrespective to status of HP. Our conclusion is that there is no correlation between HP status and NUD symptoms. To evaluate this relationship, further study must be done. To date there is no strong evidence to recommend HP eradication in HP associated NUP patients.
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The effect of colloidal bismuth subcitrate (CBS) in different doses on the rat gastric mucosal blood flow was measure by using laser dopper flow techinique. The results showed that CBS don't increase the gastric mucosal blood flow,but help to maintain a better blood flow in 20 mg,40 mg doses after the ethanol given,andCBS protected gastric mucosa of rat from ethanol-induced ulceration. This paper suggested that CBS may be decreased vascular permeability to protect the gastric mucosal blood from Ethanol damage.