四联疗法与序贯疗法在幽门螺杆菌根除补救治疗中的疗效比较  

Comparison of quadruple therapy and sequential therapy on Helicobacter pylori eradication as rescue therapy

作　　者：方辉[1] 李学良[2] 施瑞华[2] 

机构地区：[1]南通瑞慈医院消化内科,江苏南通226010 [2]江苏省人民医院消化内科,江苏南京226399

出　　处：《临床消化病杂志》2015年第1期40-42,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]比较四联疗法与序贯疗法在幽门螺杆菌(Hp)根除补救治疗中的疗效及安全性,旨在寻找一种有效、安全、经济的补救治疗方案。[方法]将首次根除Hp治疗失败的90例慢性胃炎患者,随机分为四联疗法组和序贯疗法组,每组45例。四联疗法组患者治疗方案为埃索美拉唑、枸橼酸铋钾、阿莫西林、莫西沙星,疗程14d。序贯疗法组患者治疗方案为前5d给予埃索美拉唑、阿莫西林;后5d给予埃索美拉唑、克拉霉素、奥硝唑。所有患者在疗程结束停药4周后行14 C尿素呼气试验检测Hp。比较2组患者治疗前后的不良反应。[结果]四联疗法组Hp根除率(91.1%)显著高于序贯疗法组(75.6%),差异有统计学意义(P<0.05)。2组不良反应均很轻微,组间不良反应发生率比较差异无统计学意义(P>0.05)。[结论]对于Hp补救治疗,四联疗法较序贯疗法疗效更好,且不良反应小,患者依从性好,值得在临床上推广。[Objective]The patients which failed to first-line treatment were treated with quadruple therapy or sequential therapy,and then the efficacy and safety of the Helicobacter pylori（Hp）eradication were compared.The aim of this study is to find an efficient,safe and economical rescue therapy.[Methods]Ninty patients with Hppositive chronic gastritis who had failed to eradication after 7d therapy were randomly divided into the quadruple therapy group and the sequential therapy group.The quadruple therapy group（45 patients）were treated with esomeprazole,potassium citrate,amoxicillin,and moxifloxacin for 14 days.The sequential therapy group（45patients）were treated with esomeprazole and amoxicillin for the first5 days,and followed esomeprazole,clarithromycin and ornidazole for the later 5days.Four weeks after the Hperadication therapy,detected Hpby 14C-urea breath test in all patients.The side-effects were compared between the two groups before and after treatment.[Results]The Hperadication rate in the quadruple therapy group（91.1%）was significantly higher than that in the sequential therapy group（75.6%）and the difference was statistically significant（P〈0.05）.The incidence of adverse reactions was very slight in two groups,and there was no significant difference（P〉0.05）.[Conclusion]In the patients failed to the first-line treatment,the quadruple therapy is more effective than the sequential therapy.The quadruple therapy has little adverse reactions and good eradication effect,which suggests that it＇s worth of clinical use.

关 键 词：幽门螺杆菌 四联疗法 序贯疗法 补救治疗 

分 类 号：R57[医药卫生—消化系统]