四联疗法根治幽门螺旋杆菌感染疗效分析  

Analysis of the therapeutic effectiveness of a quadruple drug therapy to eradicate Helicobacterpylori

作　　者：张健[1] 李洪运[1] 

机构地区：[1]济宁市第一人民医院,山东济宁272011

出　　处：《中国病原生物学杂志》2014年第8期747-749,共3页Journal of Pathogen Biology

摘　　要：目的探讨四联疗法治疗幽门螺杆菌(Hp)所致消化性溃疡和胃炎的疗效。方法将317例消化性溃疡和慢性萎缩性胃炎患者随机分为标准三联疗法组、四联7d组和四联10d组。四联疗法组采用左氧氟沙星+阿莫西林+奥美拉唑+枸橼酸铋钾胶囊,治疗周期分别为7d和10d。三联疗法采用奥美拉唑+克拉霉素+阿莫西林,治疗周期14d。结果采用PP分析法计算Hp根除率三联疗法组为78.43%,四联7d组为85.71%,四联10d组为91.00%,差异有统计学意义(P<0.05);采用ITT分析法计算3组的Hp根除率分别为76.19%、83.33%和87.50%,差异无统计学意义(P>0.05);总有效率分别为81.37%、85.71%和89.00%,差异无统计学意义(P>0.05)。三联疗法、四联7d组和四联10d组的成本-效果比分别为4.12、2.58、3.47,四联7d组与四联10d组相对于标准三联组的增量成本-效果比值分别为-14.11和-0.64。结论四联7d及10d方案均具有较高的Hp根除率,两种方案均为安全、有效、经济的一线治疗方案,符合我国国情,值得临床推广。Objective To determine the therapeutic effectiveness of a quadruple drug therapy to treat gastric ulcers and chronic atrophy gastritis caused by Helicobacter pylori. Methods Three hundred and seventeen patients with gastric ulcers and chronic atrophy gastritis were randomly divided into a quadruple drug therapy group and a control group.The quadruple drug therapy group was treated with 4drugs（levofloxacin,amoxicillin,omeprazole,and bismuth potassium citrate capsules）for 7or 10 days.The control group was treated with omeprazole,clarithromycin,and amoxicillin for 14 days. Results According to PP analysis,the rate of H.pylori eradication was 78.43%in the triple drug therapy group,85.71%in the 7-day quadruple drug therapy group,and 91.00%in the 10-day quadruple drug therapy group.According to ITT analysis,the rate of H.pylori eradication in the three groups was 76.19%,83.33%,and 87.50%,respectively.There were significant differences in the rates of H.pylori eradication among the three groups according to PP analysis and ITT analysis.The cost-effectiveness ratio for the first group was 4.12,that for the second was 2.58,and that for the third was 3.47.The incremental cost-effectiveness ratio for the 7-day quadruple drug therapy group was-14.11 and the ratio for the 10-day quadruple drug therapy group was-0.64 in comparison to the control group. Conclusion The 7and 10-day quadruple drug regimens had a higher rate of H.pylori eradication.The quadruple drug therapy is safe,effective,and economical first-line therapy.This therapy is suited to conditions in China and warrants greater clinical use.

关 键 词：幽门螺杆菌 胃溃疡 四联疗法 

分 类 号：R378.911[医药卫生—病原生物学]