序贯疗法和四联疗法对幽门螺杆菌初治失败患者的疗效评价  

Sequential therapy versus quadruple therapy in the management of Helicobacter pylori infection after initial treatment failure

作　　者：张春红 魏金文[2] 程兆明[2] 吴莺[2] 黄红梅[2] 

机构地区：[1]镇江市新区大路卫生院,江苏省镇江市212134 [2]江苏大学附属医院消化科,江苏省镇江市212001

出　　处：《世界华人消化杂志》2011年第22期2395-2398,共4页World Chinese Journal of Digestology

摘　　要：目的:评价含左氧氟沙星序贯疗法和含铋剂四联疗法治疗根除失败的幽门螺杆菌感染患者的疗效以及发生的不良反应.方法:将98例经传统标准三联疗法(7d)根除幽门螺杆菌失败的患者,随机分成治疗组和对照组.治疗组(序贯疗法)方案为前5d雷贝拉唑+左氧氟沙星,后5d雷贝拉唑+克拉霉素+呋喃唑酮,疗程10d.对照组(四联疗法)方案为质子泵抑制剂+克拉霉素+甲硝唑+铋剂,疗程7d.治疗结束至少4wk后,通过13C-尿素呼吸试验判断根除幽门螺杆菌效果,并评价耐受性.结果:序贯疗法(治疗组)幽门螺杆菌根除率为83.0%,四联疗法(对照组)幽门螺杆菌根除率为68.2%,两组间比较差异有统计学意义(P<0.05).不良反应发生率相似,无严重的不良反应病例.结论:含左氧氟沙星序贯疗法(10d)和含铋剂四联疗法(7d)均是治疗根除幽门螺杆菌感染失败患者有效的补救措施,而不良反应均不明显.但含左氧氟沙星序贯疗法疗效更为满意.AIM： To evaluate the efficacy and safety of levofloxacin-containing sequential therapy versus bismuth-containing quadruple therapy in the management of Helicobacter pylori （H.pylori） infection after initial treatment failure.METHODS： Ninty-eight patients who had failed eradication of H.pylori infection using traditional standard triple therapy were enrolled and randomly divided into treatment group and control group. The treatment group underwent a 10-day sequential therapy, which consisted of rabeprazole and levofloxacin for the first 5 days, and rabeprazole, clarithromycin and furazolidone for another 5 days. The control group received a 7-day quadruple therapy, which consisted of proton pump, clarithromycin inhibitors, criterion, and bismuth. The curative effects were estimated using the urea breath test four weeks after the treatment, and the safety was also evaluated.RESULTS： The eradication rate of H.pylori infection was 83.0% in the treatment group and 68.2% in the control group. There was a significant difference in the eradication rate of H.pylori infection between the two groups （P 〈 0.05）. The incidence of adverse reactions was comparable between the two groups, and no serious adverse reactions occurred.CONCLUSION： Although both sequential therapy and quadruple therapy are effective and safe in the management of H.pylori infection after initial treatment failure, sequential therapy is associated with better efficacy.

关 键 词：序贯疗法 幽门螺杆菌 左氧氟沙星 四联疗法 

分 类 号：R57[医药卫生—消化系统]