序贯疗法治疗幽门螺杆菌阳性消化性溃疡的疗效观察  

Sequential Treatment for Helicobacter Pylori Eradication in Peptic Ulcer Patients

作　　者：张凤玉[1] 黄晓曦[1] 

机构地区：[1]新疆自治区人民医院,新疆乌鲁木齐市830001

出　　处：《中国全科医学》2010年第33期3813-3814,共2页Chinese General Practice

摘　　要：目的比较10 d序贯疗法与7 d、14 d三联疗法根治幽门螺杆菌(H.pylori)的疗效及安全性。方法选取113例胃镜证实为消化性溃疡的患者,且行14C尿素呼气试验发现H.pylori阳性。将患者随机分为3组:A组(序贯疗法组,39例)前5 d给予泮托拉唑和阿莫西林,后5 d给予泮托拉唑、替硝唑、克拉霉素治疗;B组(7 d三联疗法)给予泮托拉唑、阿莫西林、克拉霉素治疗,疗程为7 d;C组(14 d三联疗法)方案同B组,但疗程为14 d。疗程结束1个月后3组患者均行14C尿素呼气试验检测H.pylori。比较3组患者H.pylori根除率及不良事件发生率。结果 A、C组患者H.pylori根除率分别为92.3%(36/39)和97.1%(34/35),均显著高于B组的73.0%(27/37),差异有统计学意义(P<0.05);而A组与C组的H.pylori根除率间差异无统计学意义(P>0.05)。A、B、C组患者治疗后不良事件发生率分别为15.4%(6/39)、13.5%(5/37)和20.0%(7/35),3组比较差异无统计学意义(P>0.05)。结论 10 d序贯疗法的疗效与14 d三联疗法的疗效均较7 d三联疗法好,且安全,但10 d序贯疗法的费用-效益比更高。Objective To assessthe eradication andsafety of a10-day sequential regimencomparedwithconvention-al 7-day and 14-day triple therapies.Methods Overall,113 H.pylori-infected patients with peptic ulcer were enrolled.patients were randomized to receive 10-day sequential therapy〔pantoprazole（40 mg twice daily） plus amoxicillin（1 g twice daily） for the first 5 days followed by pantoprazole（20 mg）,clarithromycin（500 mg） and tinidazole（500 mg） twice daily for the remaining 5 days〕or standard 7-day therapy（corrected） 〔pantoprazole（20 mg）,clarithromycin（500 mg） andamoxicillin（1 g） twice daily〕,or standard 14-day therapy.Four weeks after therapy,H.pylori eradication was assessed by 14C-urea breath test.Adverse drug event were compared in three groups.Results H.pylori eradication was achieved in 36（92.3%） of 39 individuals in group A,34（97.1%） of 35 in group C and 27（73.0%） of 37 in group B.Sequential regimen and the 10-day showed a significant gain in the eradication rate as compared to the 7-day（P 0.05） while there was no significant difference between group A and group C（P 0.05）.Adverse drug events were similar in these three regimens（P 0.05）.Conclusion The sequential regimen and standard 14-day therapy achieved higher cure rate than standard 7-day therapy.The 10-day sequential regimen and 14-day triple therapies were more effective than 7-day triple therapies.

关 键 词：泮托拉唑 阿莫西林 替硝唑 克拉霉素 序贯疗法 消化性溃疡 幽门螺杆菌 

分 类 号：R573.1[医药卫生—消化系统]