新序贯疗法与三联疗法治疗幽门螺杆菌阳性萎缩性胃炎的疗效比较  

Comparison of a new sequential therapy and triple therapy on patients of atrophic gastritis with Helicobacter pylori infection

作　　者：刘艳[1] 胡红松[1] 李学锋[1] 黄妙娟[1] 陈晓红[1] 黄素娴[1] 俞红华[1] 

机构地区：[1]广东省深圳市龙岗区人民医院消化内科,518172

出　　处：《实用医学杂志》2012年第8期1343-1345,共3页The Journal of Practical Medicine

摘　　要：目的:比较由埃索美拉唑、阿莫西林、左氧氟沙星、呋喃唑酮组成的新序贯疗法与三联疗法治疗幽门螺杆菌(Hp)阳性萎缩性胃炎的疗效。方法:80例Hp阳性的萎缩性胃炎患者随机分为两组:治疗组采用新序贯疗法:前5d口服埃索美拉唑片20mg+阿莫西林胶囊1000mg,每日2次,后5d改为埃索美拉唑片20mg+左氧氟沙星胶囊200mg+呋喃唑酮片100mg,每日2次;对照组采用三联疗法:埃索美拉唑片20mg+阿莫西林胶囊1000mg+左氧氟沙星胶囊200mg,每日2次,口服7d。所有患者在治疗前、停药3个月后观察症状改善情况、Hp清除率和病理组织学改变。结果:治疗组症状明显缓解,有效率87.50%,较对照组70.00%显著提高;Hp清除率治疗组为92.50%,对照组为80.00%,差异有显著性;且症状积分、病理积分、胃黏膜萎缩程度差异均有统计学意义(P<0.05)。结论:新序贯疗法对Hp阳性萎缩性胃炎患者Hp根除效果明显好于三联疗法,Hp根除后临床症状及胃黏膜萎缩程度可显著改善。Objective To compare the therapeutic effects of a new sequential therapy and triple therapy on patients of atrophic gastritis with Helicobacter pylori （Hp） infection. Methods 80 patients of atrophic gastritis with Hp infection were randomly divided into 2 groups ： treated group and control group. 40 cases of treated group took a new sequential therapy , which consisted of a 10 day treatment including esomeprazole 20 mg bid plus amoxicillin 1 000 mg bid for the first 5 days, followed by esomeprazole 20 mg bid, levofloxacin 200 mg bid and furazolidone 100 mg bid for the next 5 days. 40 cases of control group took esomeprazole 20 mg bid, amoxicillin 1 000 mg bid, levofloxacin 200 mg bid for 7 days. Two groups were compared with differences of symptom scale scores,Hp eradication rates and histopathological changes after 3 months. Results There was significant difference in total effective rate between treated group （87.50%） and control group （70.00%） （P 〈 0.05）. The Hp eradication rate of treated group was 92.50% and 80.00% in control group, and there was significant difference between the two groups （P 〈 0.05）. The symptom scale scores,histopathological scores and gastric atrophy of the treatment group were better than those of control group （P 〈 0.05）. Conclusion The new sequential therapy including esomeprazole, amoxieillin, levofloxacin and furazolidone has a better Hp eradication effect for Hp positive atrophic gastrits patients than standard triple therapy ; the clinical symptoms and gastric atrophy can be greatly improved after Hp eradication.

关 键 词：萎缩性胃炎 序贯疗法 幽门螺杆菌 左氧氟沙星 呋喃唑酮 

分 类 号：R573.3[医药卫生—消化系统]