10日序贯疗法治疗幽门螺杆菌感染39例  

A 10-day sequential therapy for Helicobacter pylori-infected patients:an analysis of 39 cases

作　　者：胡水清[1] 张玫[1] 

机构地区：[1]首都医科大学宣武医院消化科,北京市100053

出　　处：《世界华人消化杂志》2009年第16期1693-1695,共3页World Chinese Journal of Digestology

摘　　要：目的:比较埃索美拉唑、阿莫西林、克拉霉素、替硝唑组成的10日序贯疗法与标准三联疗法根除幽门螺杆菌(Hpylori)的疗效.方法:将我院经胃镜检查确诊为慢性胃炎和消化性溃疡且Hpylori阳性的患者79例随机分为2组,治疗组(39例)方案:前5d,埃索美拉唑20mg+阿莫西林1000mg,每日2次;后5d,埃索美拉唑20mg+克拉霉素500mg+替硝唑500mg,每日2次.对照组(40例)标准三联疗法:埃索美拉唑20mg+克拉霉素500mg+阿莫西林1000mg,每日2次,疗程7d.所有患者停药4wk后复查13C呼气试验,判断Hpylori根除率.结果:治疗组Hpylori根除率为94.87%,对照组77.50%,2组比较差异具有统计学意义(χ2=4.97,P<0.05),且序贯疗法并未增加患者的经济负担.2种方案不良方应的发生率无明显差异(χ2=0.05,P>0.05).结论:10日序贯疗法治疗Hpylori感染明显优于7日标准三联疗法,是一种安全、经济、有效的方案选择.AIM： To determine whether the sequential therapy is better than the standard triple-drug therapy in treatment of H pylori infection for adults with chronic gastritis and peptic ulcer. METHODS： Seventy-nine patients with H pylori positive were randomly divided two groups. Thirty nine patients received a 10-day sequential therapy [esomeprazole （20 mg, twice daily） plus amoxicillin （1000 mg, twice daily） for the first 5 days, followed by esomeprazole （20 mg）, clarithromycin （500 mg） and tinidazole （500 mg） twice daily for the remaining 5 days]. Forty patients received a 7-day triple therapy [esomeprazole （20 mg）, clarithromycin （500 mg） and amoxicillin 1000 mg, twice daily]. H pylori eradi- cation was checked four weeks after treatment using 13C-urea breath test. RESULTS： The eradication rate of the 10-day sequential therapy was 94.87%, and merely 77.50% for the control group. The difference between the two groups was significant （;（2 = 4.97, P 〈0.05）. There was no difference in incidence of side effects between the two groups （X2=0.05, P 〉 0.05）. CONCLUSION： The 10-day sequential therapy achieves a higher eradication rate than the standard triple therapy for the first time in adults. It is an effective, safe and economical option for patients and possesses great potential.

关 键 词：序贯疗法 幽门螺杆菌 三联疗法 根除率 

分 类 号：R573[医药卫生—消化系统]