含铋剂四联疗法作为一线方案根除幽门螺杆菌的临床研究  

Clinical study of bismuth-based quadruple therapy as first-line therapy for the eradication of Helicobacter pylori.

作　　者：章金艳[1] 刘明[1] 栗华[1] 郑建玮[1] 林冠霞[1] 陈雅真[1] 

机构地区：[1]厦门大学附属第一医院消化内科,福建厦门361003

出　　处：《海南医学》2012年第12期12-14,共3页Hainan Medical Journal

摘　　要：目的评价含铋剂的四联10d疗法作为一线方案治疗幽门螺杆菌感染的有效性和安全性。方法将140例幽门螺杆菌感染的初治患者随机分为三联治疗组和四联治疗组各70例。三联治疗组给予埃索美拉唑20mgbid+克拉霉素500mgbid+阿莫西林1.0gbid治疗7d,四联治疗组给予埃索美拉唑20mg bid+克拉霉素500mg bid+阿莫西林1.0g,bid+果胶铋150mgtid治疗10d。疗程结束6周后复查13C-尿素呼气试验,判断幽门螺杆菌根除情况,同时观察治疗过程中的不良反应。结果三联治疗组按方案(PP)分析和按意向治疗(ITT)分析H.pylori的根除率分别为76.5%、74.3%,四联治疗组按PP和按ITT分析根除率分别为92.5%、88.6%,四联治疗组按PP和ITT分析H.pylori的根除率均高于三联治疗组(P值分别为0.010、0.030)。两组不良反应发生率相似,无严重的不良反应病例。结论含铋剂的四联10d疗法用于幽门螺杆菌感染的初治,疗效高于标准三联7d疗法,是一种可供选择的一线治疗方案。Objective To evaluate the efficacy and safety of the 10-day bismuth-based quadruple therapy as first-line therapy for the eradication of Helicobacter pylori. Methods A total of 140 patients with H. pytori infection were enrolled and randomly assigned into triple therapy groups and quadruple therapy groups, each with 70 cases. Pa- tients in the triple therapy group received esomeprazole 20 mg BID, clarithromycin 500 mg BID and amoxicillin 1.0 g BID for seven days. Patients in the quadruple therapy group received esorneprazole 20 mg BID, clarithromycin 500 mg BID, amoxicillin 1.0 g BID and pectin bismuth 150 nag TID for ten days. H. pylori eradication was assessed by13C-urea breath test six weeks after cessation of therapy, and the safety was also evaluated. Results The per-proto- col （PP） and intention-to-treat （ITT） eradication rates were 76.4% and 74.3% in the triple therapy group, and 92.5% and 88.6% in the quadruple therapy group, respectively. The eradication rate was significantly higher in the quadruple therapy group compared with the triple therapy group in both the PP and ITT populations （P=0.010 and P=0.030, re- spectively）, whereas the incidence of adverse events was similar. No serious adverse reactions occurred in the two groups. Conclusion In the initial treatment of H. pylori infection, the 10-day bismuth-based quadruple therapy as first-line therapy can achieve a higher eradication rate than the 7-day standard triple therapy.

关 键 词：幽门螺杆菌 四联疗法 标准三联疗法 

分 类 号：R378.2[医药卫生—病原生物学]