青岛地区3种根除幽门螺杆菌治疗方法的临床观察比较  

Anti-Helicobacter pylori eradication therapy in Qingdao area:a comparison of three theapeutic regimens

作　　者：魏东卉[1] 杨楠[2] 王志[3] 王朝周[2] 王芬娟[2] 郭晨雯[2] 

机构地区：[1]青岛市市立医院药学部,青岛266011 [2]青岛市人民医院,青岛266001 [3]青岛大学医学院附属医院药学部,青岛266002

出　　处：《军事医学科学院院刊》2007年第2期152-154,共3页Bulletin of the Academy of Military Medical Sciences

基　　金：青岛市医药科研指导计划基金资助项目(2003-wszd021)

摘　　要：目的:通过观察奥美拉唑、克拉霉素、阿莫西林、甲硝唑、呋喃唑酮不同分组短程三联疗法的临床疗效,确定青岛地区用于治疗幽门螺杆菌抗生素的耐药率,选择最合适的三联治疗方案,避免新的耐药菌株的出现。方法:396例消化性溃疡或浅表性胃炎合并幽门螺杆菌阳性患者,随机分为3组:①奥美拉唑20mg+克拉霉素500mg+阿莫西林1000mg组,132例;②奥美拉唑20mg+阿莫西林1000mg+甲硝唑400mg组,132例;③奥美拉唑20mg+阿莫西林1000mg+呋喃唑酮100mg组,132例。2次/d,每个疗程7d。抗幽门螺杆菌治疗结束后1个月,全部做胃镜检查。结果:3组幽门螺杆菌的根除率分别为86.12%(112/130)、59.23%(77/130)和92.24%(122/132),耐药率分别为13.88%、40.77%和7.58%,①组和③组间差异无统计学意义(χ2=2.7,P>0.05),而②组的根除率、耐药率与①组和③组间经χ2检验,差异有统计学意义(P<0.01)。3组的消化性溃疡愈合率分别为61.11%、48.64%和82.86%,①组和②间差异无统计学意义(χ2=1.14,P>0.05),③组与①组和②组间经χ2检验,差异有统计学意义(P<0.01);不良反应发生率分别为2.3%(3/130)、8.5%(11/130)和6.1%(8/132)。结论:青岛地区根除幽门螺杆菌的三联疗法首选方案为:①奥美拉唑20mg+克拉霉素500mg+阿莫西林1000mg组和③奥美拉唑20mg+阿莫西林1000mg+呋喃唑酮100mg组。Objective：To choose the best therapeutic regimen for eradicating Helicobacter pylori and avoiding appearance of new resistant isolates, through observing the clinical result of omeprazole, clarithromycin, amoxicillin, metronidazole and furazolidone in different triple-drug therapy, Methods：Three hundred eighty nine HP positive patients with peptic ulcer or superficial gastritis were divided into thee groups and drugs were given as follows： each of the 132 patients of the first group was given omeprazole 20 mg ＋ clarithromycin 500 mg ＋ amoxicillin 1 000 mg; each of the 132 patients of the second group was given omeprazole 20 mg＋ amoxicillin 1 000 mg ＋ metronidazole 400 mg;each of the 132 patients of the third group was given omeprazole 20 mg ＋ amoxicillin 1 000 mg ＋ furazolidone 100 mg. All drugs were given two times a day for seven days. Gastroscopy was performed after one month. Results： The HP eradication rate was 86.12% （112/130） in the first group, 59.23% （77/130） in the second group and 92.24% （122/132） in the third group. The antibiotic resistance rate was 13. 88% in the first group, 40.77% in the second group and 7.58% in the third group. The results between the first group and the third group were without significant difference（χ^2 =2. 7,P 〉0.05） ,the results between the second group and the first group were different significantly （χ^2 = 23.74,P 〈 0.01 ）, and the results between the second group and the third group were different significantly（χ^2 = 39. 51 ,P 〈 0.01 ）. The healing rate of peptic ulcer was 61.11% in the first group, 48. 64% in the second group and 82.86% in the third group. The results between the first group and the second group were without significant difference（χ^2 = 1.14 ,P 〉0.05） ,the results between the third group and the first group were different significantly（χ^2 =4. 15,P 〈0.05） ,and the results between the third group and the second group were different significantly（χ^2 =9. 29 ,P 〈0.01 ）. The rate of AD

关 键 词：幽门螺杆菌 根除 治疗方案 

分 类 号：R573[医药卫生—消化系统]