序贯疗法和标准三联疗法根除幽门螺杆菌的疗效比较  

Sequential therapy versus standard triple therapy for Helicobacter pylori eradication

作　　者：吴改玲[1] 蓝宇[1] 张小晋[1] 

机构地区：[1]北京积水潭医院消化内科,北京市100035

出　　处：《世界华人消化杂志》2011年第29期3100-3103,共4页World Chinese Journal of Digestology

摘　　要：目的:观察10d序贯疗法治疗幽门螺杆菌(Helicobacter pylori,H.pylori)的疗效及不良反应,与14d三联标准疗法比较H.pylori根除情况及经济学上有无优越性.方法:将103例经胃镜检查确诊为慢性胃炎或消化性溃疡且H.pylori阳性的患者随机分为两组,治疗组(10d序贯疗法)52例,前5d埃索美拉唑、阿莫西林,后5d埃索美拉唑、克拉霉素、替硝唑.对照组(14d标准三联疗法)51例,埃索美拉唑、阿莫西林、克拉霉素14d.所有患者停药4wk后复查13C呼气试验或胃镜检查,判断H.pylori根除情况.结果:治疗组H.pylori根除率为90.4%,与对照组(90.2%)比较无统计学差异(P=1.000);两组不良反应发生率分别为12/52(23.1%)、18/51(35.3%),两组比较无统计学差异(P=0.172);治疗组费用为380.6元,较对照组(677.88元)明显减低.结论:10d序贯疗法的H.pylori根除率不低于标准14d三联疗法,2组不良反应发生率相似,但10d序贯疗法根除H.pylori的效价比更高.AIM： To assess the efficacy and safety of a new sequential treatment regimen versus standard triple therapy for Helicobacter pylori （H.pylori） infection. METHODS： One hundred and two H.pylori-infected patients with chronic gastritis or peptic ulcer were randomized to receive a 10-day sequential therapy [esomeprazole （20 mg, twice daily） plus amoxicillin （1000 mg, twice daily） for the first 5 d, followed by esomeprazole （20 mg）, clarithromycin （500 mg） and tinidazole （500 mg） twice daily for the remaining 5 d] or a 14-day standard triple therapy [esomeprazole （20mg）, clarithromycin （500 mg） and amoxicillin 1000 mg, twice daily]. H.pylori status was evaluated by 13C-urea breath test or endoscopy four weeks after completion of treatment. RESULTS： There were no significant differences in the eradication rate of H.pylori infection （90.4% vs 90.2%, P = 1.000） and the incidence of side effects （23.5 % vs 35.3%, P = 0.172） between the 10-day sequential regimen group and 14-day standard regimen group. The treatment cost was significantly lower for the 10-day sequential therapy than for the 14-day standard triple therapy （380.6 yuan vs 677.88 yuan, P 0.05）. CONCLUSION： The 10-day sequential treatment regimen has similar eradication rate of H.pylori infection and incidence of side effects but higher cost-efficiency compared to the 14-day standard triple therapy.

关 键 词：序贯疗法 标准三联疗法 幽门螺杆菌 根除率 

分 类 号：R57[医药卫生—消化系统]