含多西环素的四联方案补救治疗幽门螺杆菌初次根除失败的临床研究  

Clinical Study of Doxycycline-based Quadruple Regimen as a Rescue Therapy after Failure of Initial Eradication Therapy of Helicobacter pylori

作　　者：王震华[1] 熊光苏[1] 杨川华[1] 王勇峰[1] 吴叔明[1] 

机构地区：[1]上海交通大学医学院附属仁济医院消化内科上海市消化疾病研究所,200001

出　　处：《胃肠病学》2011年第4期211-213,共3页Chinese Journal of Gastroenterology

摘　　要：背景:幽门螺杆菌(H.pylori)一线三联疗法的根除失败率日益增高。目的:评价含多西环素的四联方案补救治疗H.pylori初次根除失败的有效性和安全性。方法:共纳入37例H.pylori初次根除失败的消化性溃疡、慢性萎缩性胃炎或非溃疡性消化不良患者,予四联方案埃索美拉唑(20 mg)+枸橼酸铋钾(220 mg)+多西环素(100 mg)+阿莫西林(1000 mg),2次/d×10 d。治疗结束4周后行13C-尿素呼气试验(UBT)以评估H.pylori根除情况。结果:4例患者失访,25例患者补救治疗成功,8例失败,补救治疗意向治疗(ITT)分析和符合方案(PP)分析根除率分别为67.6%和75.8%。21例(63.6%)患者发生轻微不良反应。结论:含多西环素的四联方案是一种安全、有效的H.pylori初次根除失败后的补救治疗方案。The failure rate of first-line triple therapy for Helicobacter pylori （H. pylori） is increasing in recent years. Aims： To assess the efficacy and safety of doxycycline-based quadruple regimen as a rescue therapy after failure of initial eradication therapy of H. pylori. Methods： Thirty-seven patients with peptic ulcer, chronic atrophic gastritis or non-ulcer dyspepsia, who had a failed course of initial eradication therapy, were given the following quadruple therapy： esonaeprazole （20 nag）＋bismuth potassium citrate （220 nag）＋doxycycline （100 mg）＋anaoxicillin （1000 nag）, twice daily for l0 days. The status of H. pylori was assessed by 13C-urea breath test （UBT） 4 weeks after therapy. Results： Four patients dropped out in the follow-up study, 25 patients had their H. pylori successfully eradicated, and 8 patients remained H. pylori positive. The H. pylori eradication rates of rescue therapy by intention-to-treat （ITT） and per-protocol （PP） analysis were 67.6% and 75.8%, respectively. Slight or mild side effects occurred in 21 （63.6%） patients. Conclusions： Doxycycline-based quadruple regimen is a safe and effective rescue therapy after a failed initial eradication therapy.

关 键 词：多西环素 螺杆菌 幽门 药物疗法 治疗 临床研究性 

分 类 号：R57[医药卫生—消化系统]