含呋喃唑酮四联疗法对幽门螺杆菌多次根除失败患者的效果  

Efficacy of furazolidone-based quadruple therapy as rescue treatment for refractory Helicobacter pylori infection

作　　者：郑小丽[1] 许乐[1] 

机构地区：[1]卫生部北京医院消化内科,100730

出　　处：《中华医学杂志》2013年第44期3496-3499,共4页National Medical Journal of China

摘　　要：目的 评价含呋喃唑酮的四联疗法对既往多次根除幽门螺杆菌（H.pylori）失败患者的效果和安全性.方法 采用前瞻性随机对照临床研究,对象为既往H.pylori感染根除治疗2次或以上的患者,2011年7月至2013年6月北京医院消化科门诊156例符合入选标准的患者被纳入,其中男91例、女65例.将入选患者按随机数字表法随机分为呋喃唑酮组（80例）和左氧氟沙星组（76例）,分别给予含呋喃唑酮的四联疗法（埃索美拉唑镁20 mg 2次/d＋呋喃唑酮100 mg 2次/d＋阿莫西林1000 mg 2次/d＋胶体果胶铋150 mg 3次/d）和含左氧氟沙星的四联疗法（埃索美拉唑镁20 mg 2次/d＋左氧氟沙星500 mg 1次/d＋阿莫西林1000 mg 2次/d＋胶体果胶铋150 mg 3次/d）,疗程均为10d,治疗结束后4周做13C尿素酶呼气试验比较H.pylori根除疗效.结果 呋喃唑酮组76例完成治疗及随访,其中67例补救治疗成功,其按意向治疗（ITT）和按符合方案（PP）H.pylori根除率分别为83.8％ （67/80）和88.2％（67/76）;左氧氟沙星组72例完成治疗及随访,53例根除治疗成功,其ITT和PP H.pylori根除率分别为69.7％（53/76）和73.6％ （53/72）;呋喃唑酮组H.pylori根除率高于左氧氟沙星组,差异均有统计学意义（x2 =4.311、5.100,P=0.038、0.024）.结论 对既往多次H.pylori根除治疗失败的患者,埃索美拉唑＋呋喃唑酮＋阿莫西林＋胶体果胶铋10 d疗法是疗效较好的补救治疗方案.Objective To evaluate the efficacy and tolerability of a furazolidone-based quadruple rescue regimen in patients with previously failed Helicobacter pylori （H.pylori） eradication treatment.Methods A total of 156 patients were recruited from July 2011 to June 2013 at Beijing Hospital and randomized into one of the following 10-day treatment regimens：（1） Esomeprazole 20 mg twice daily,furazolidone 100 mg twice daily,amoxicillin 1000 mg twice daily,bismuth salts 150 mg thrice daily for 10 days.（2） Esomeprazole 20 mg twice daily,levofloxacin 500 mg daily,amoxicillin 1000 mg twice daily,bismuth salts 150 mg thrice daily for 10 days.H.pylori status was re-assessed with the 13C-urea breath test at 4 weeks after the end of therapy.Results The intention-to-treat （ITT） and per-protocol （PP） H.pylori eradication rates were 83.8％ （67/80） and 88.2％ （67/76） in the furazolidone-based quadruple group,and 69.7％ （53/76） and 73.6％ （53/72） in the levofloxacin-based quadruple group respectively （x2 =4.311,5.100;P =0.038,0.024）.Conclusion The 10-day furazolidone-based quadruple therapy is an efficious rescue strategy in patients with previously failed eradication therapy.

关 键 词：螺杆菌 幽门 呋喃唑酮 补救治疗 

分 类 号：R573[医药卫生—消化系统]