[Efficacy of different schemes of anti-helicobacter therapy in duodenal ulcer]. / Effectivnost' razlichnykh skhem antikhelikobakternoi terapii pri iazvennoi bolezni dvenadtsatiperstnoi kishki.

AIM: To study clinical efficacy and antihelicobacter activity of combined treatment of duodenal ulcer (DU) with famotidin (qamatel), metronidasol (trichopol) and jozamycin (walpraphen). MATERIAL AND METHODS: A total of 96 patients with uncomplicated DU have been treated (mean age 42.5 +/- 1.5 years). The examination included standard tests, endoscopy, pH-metry (on the treatment days 1, 15 and 28), biopsies and prints from the antral stomach and its body. The sections were stained by Gimse for morphological assessment of duodenal mucosa and detection of Helicobacter pylori (HP). Gastric acid-producing function was examined with intragastric pH-metry. The patients were divided into 3 groups: group 1 received monotherapy with famotidin (20 mg twice a day); group 2 received combined treatment with famotidin (40 mg/day), metronidasol (500 mg twice a day), josamycin (300 mg in 3 doses) for a week with following intake of famotidin alone (40 mg/day) for 3 weeks; group 3 received the same treatment plus clarythromycin. Group 1 patients benefited from the treatment but elimination of pain and dyspeptic syndromes was longer than in groups 2 and 3 (p < 0.05). Ulcer healing to treatment day 28 was observed in 71.8, 90.0 and 88.2%, respectively. Side effects occurred in 0, 10 and 16.7% cases, respectively. CONCLUSION: 1-week schemes of combined treatment with famotidin, metronidasol, josamycin or clarythromycin are highly effective in DU and their side effect rates are not very high.

[Experience in the use of immunomodulator likopid in ulcer disease]. / Opyt primeneniia immunomoduliatora likopida pri iazvennoi bolezni.

We studied the effect of immunomodulator likopid on leukocytic immunity and duodenal ulcer (DU) course in 92 DU patients (70 males, 22 females; mean age 32 +/- 1.2 years) having positive tests for Helicobacter pylori. The diameter of ulcer defects in the duodenal bulb ranged from 0.2 to 1.3 cm, mean size of ulcer was 0.8 +/- 0.1 cm. We measured lymphocyte population with rosette formation test, T-lymphocyte subpopulation by determination of sensitivity to teophylline, humoral immunity--with Manchini. The addition of likopid to present-day antiulcer therapy with antisecretory and antihelicobacter drugs shortens ulcer healing by 3-4 days, raised H. pylori eradication to 100%. In the course of the treatment lymphocyte and monocytes count increased, neutrophil count reduced. The course treatment normalized cellular immunity: count of T-lymphocytes rose to 1.27 x 10(9) +/- 0.01 to 1.78 x 10(9) +/- 0.04 g/l (p < 0.05), T-suppressors--from 11.36 +/- 0.56 to 14.05 +/- 0.52% (p < 0.05), count of B-lymphocytes fell from 32.44 +/- 0.31 to 28.7 +/- 0.28%. A positive trend in the number of T-lymphocytes was accompanied with normalization of T-helpers/T-suppressors which increased from 2.51 +/- 0.21 to 3.52 +/- 0.18 (p < 0.01). CIC tended to lowering from 118.1 +/- 0.43 to 110.6 +/- 0.27 U (p < 0.05). Complement concentration in the serum rose from 30.1 +/- 0.3 to 32.6 +/- 0.2 (p < 0.001). This improved DU course. Thus, inclusion of likopid improves immune status of the patients, free radical oxidation of lipids and, consequently shortens ulcer healing.

[Clinical efficacy of combined anti-Helicobacter treatment of patients with duodenal ulcer]. / Klinicheskaia effektivnost' kombinirovannogo antikhelikobakternogo lecheniia bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

84 patients with duodenal ulcer and positive by Helicobacter pylori (HP) were divided into two groups. Group 1 consisted of 42 patients who received omeprasol, metranidasol and clarithromycin. Group 2 of 42 patients received rovamycin instead of clarythromycin. The results of the study show that anti-HP regimen with rovamycin is superior to clarythromycin by main criteria (percent of healed ulcers, HP eradication, time to remission, recurrence rate, side effects rate). Thus, three-component therapy of patients with recurrent duodenal ulcer maintains intragastric acidity optimal for fast healing of ulcer defect.