左金丸联合三联与铋剂四联疗法在幽门螺杆菌根除失败后补救治疗中的疗效评价  

Efficacy of Zuojinwan combined trigeminy therapy versus bismuth-contained quadruple therapy as rescue therapies for failure of Helicobacter pylori eradication

作　　者：潘涛[1] 顾兴平[1] 刘芙成[1] 侯兵[1] 冉红梅[1] 付国川 

机构地区：[1]成都市第一人民医院消化内科,四川成都610041

出　　处：《西部医学》2013年第10期1516-1518,共3页Medical Journal of West China

摘　　要：目的评价左金丸联合三联疗法与铋剂四联疗法在幽门螺杆菌(H.pylori)根除失败后补救治疗中的疗效。方法 95例初次H.pylori根除失败的患者被随机分为A、B两组,A组(47例)给予含铋剂四联疗法:埃索美拉唑20mg、果胶铋300mg、阿莫西林1000mg、呋喃唑酮100mg,每日口服2次,疗程10天。B组(48例)给予左金丸(黄连、吴茱萸)加三联疗法:埃索美拉唑20mg、阿莫西林1000mg、呋喃唑酮100mg,每日口服2次,左金丸也分为2次口服,疗程10天。比较两组患者的H.pylori根除率、临床症状评分改善及不良反应发生率。结果 A组和B组的H.pylori ITT根除率分别为80.9%和81.3%;PP根除率分别为86.4%和84.8%,差异无统计学意义(P>0.05)。两组患者停药4周后主要临床症状缓解有效率B组高于A组(95.8%vs 78.7%,P<0.05)。A组的不良反应发生率高于B组(18.2%vs4.3%,P<0.05)。结论左金丸联合三联疗法在H.pylori根除失败后补救治疗中的疗效与铋剂四联疗法相当,且临床症状缓解有效率更高,不良反应更少,为根除H.pylori失败后的补救治疗方案提供了新的思路,值得临床推广应用。Objective To investigate the eradication efficacy of Zuojinwan combined trigeminy therapy versus bis- muth-contained quadruple therapy as rescue therapies for failure of Helicobacter pylori eradication. Methods Ninety-five patients failed H. pylori eradication therapy were randomly divided into two groups. A group （n =47） received bismuthcontained quadruple therapy., esomeprazole 20mg plus colloida bismuth pectin 300mg, amoxicillin 1000mg and furazolidone 100mg twice daily for 10 days. B group （n = 48） received Zuojinwan（coptis and evodia rutaecarpa） combined trigeminy therapy： esomeprazole 20mg plus amoxicillin 1000mg, furazolidone 100mg and Zuojinwan twice daily for l0 days. Four weeks after the therapy, the 14C-urea breath test was performed to detect H. pylori infection status. The symptom remission and the adverse effects were recorded. Results The H. pylori eradication rates achieved in A group and B group were 80.9% and 81.3% in the intent-to-treat analysis, and 86.4% versus 84.8% in the per-protocol analysis. There were no significant differences between the two groups （both P〉0.05）. The symptom remission of B group was significantly higher than A group（95.7% vs 79.5%, P〈0.05）. The adverse effects rate of A group was significantly higher than B group（18.2% vs 4.3%, P〈0.05）. Conclusion Zuojinwan combined trigeminy therapy is an effective and safe rescue regimen for patients who failed H. pylori eradication.

关 键 词：左金丸 幽门螺杆菌 补救治疗 

分 类 号：R573[医药卫生—消化系统] R975[医药卫生—内科学]