8d与10d序贯疗法根除幽门螺杆菌的疗效比较  

Eff icacy of 8-day versus 10-day sequential therapy for Helicobacter pylori eradication

作　　者：张杰[1] 段和力[1] 汪海涛[1] 

机构地区：[1]河北联合大学附属开滦医院消化科,河北省唐山市063000

出　　处：《世界华人消化杂志》2011年第30期3186-3189,共4页World Chinese Journal of Digestology

摘　　要：目的:比较雷贝拉唑、阿莫西林、克拉霉素、奥硝唑组成的8d与10d序贯疗法根除幽门螺杆菌(H.pylori)的疗效.方法:将经胃镜检查确诊为慢性胃炎和消化性溃疡,且H.pylori阳性的217例患者随机分为2组,8d组(n=104)方案:前4d,雷贝拉唑+阿莫西林;后4d,雷贝拉唑+克拉霉素+奥硝唑.10d组(n=113)方案:前5d,雷贝拉唑+阿莫西林;后5d,雷贝拉唑+克拉霉素+奥硝唑.根除治疗后复查14C-尿素呼气试验,比较两组H.pylori根除率.结果:8d组和10d组H.pyloriITT根除率分别为89.3%和91.2%,PP根除率分别为92.0%和93.7%.两种分析方法比较两组的根除率差异均无统计学意义(P>0.05),但8d序贯疗法降低了成本-效果比,减轻了患者的经济负担.两种方案症状缓解率及不良反应发生率的差异无统计学意义(P>0.05).结论:8d序贯疗法可以获得较高的H.pylori根除率和症状缓解率,且经济、安全,是一种可供选择的一线治疗方案.AIM： To compare the efficacy of 8-day versus 10-day sequential therapy in the eradication of Helicobacter pylori （H.pylori） infection. METHODS： Two hundred and seventeen patients with H.pylori infection who had peptic ulcer or chronic gastritis were randomly divided into two groups： 8-d group （n = 103, received rabeprazole 10 mg plus amoxicillin 1.0 g for 4 days, and rabeprazole 10 mg plus clarithromycin 500 mg and ornidazole 500 mg for another 4 days） and 10-d group （n = 114, received rabeprazole 10 mg plus amoxicillin 1.0 g for 5 days, and rabeprazole 10 mg plus clarithromycin 500 mg and ornidazole 500 mg for another 5 days）. All drugs were given twice daily. H.pylori infection status was compared between the two groups after completion of treatment. RESULTS： Intention-to-treat eradication rate was 89.3% and 91.2% （P0.05）, and per-protocol eradication rate was 92.0% and 93.7% （P0.05） in the 8-d and 10-d group, respectively. However, the treatment cost was lower for the 8-day group. There were no significant differences in the incidence of side effects and the rate of symptomatic relief between the two groups （both P0.05）. CONCLUSION： The 8-day sequential therapy can achieve a high H.pylori eradication and re- lieve the symptoms effectively, and may be used as rst-line treatment for H.pylori eradication.

关 键 词：序贯疗法 幽门螺杆菌 根除率 

分 类 号：R573[医药卫生—消化系统]