大剂量雷贝拉唑对含铋四联疗法幽门螺杆菌根除及症状缓解效果的影响  

A randomized controlled trial of double-dose and standard dose rabeprazole quadruple regimens for Helicobacter pylori eradication and symptom Relief

作　　者：李倩 魏红[1,2] 张秀丽 贾鹏娟[1,2] 杨桂彬 

机构地区：[1]北京大学航天临床医学院 [2]航天中心医院消化科,北京100049

出　　处：《临床药物治疗杂志》2015年第1期35-38,共4页Clinical Medication Journal

摘　　要：目的:比较不同剂量雷贝拉唑为基础的含铋四联10 d疗法幽门螺杆菌Helicobacter pylori根除率和症状缓解率。方法:H.pylori阳性的胃炎或十二指肠溃疡患者随机接受包含不同剂量雷贝拉唑的四联疗法:雷贝拉唑10 mg(A组)或20 mg(B组)、克拉霉素500 mg、阿莫西林1 000 mg和枸橼酸铋钾220 mg,bid,疗程10 d。停药4周后复查13C-呼气试验,并了解症状缓解情况。结果:共有121例患者纳入本试验,其中A组60例,B组61例。A组H.pylori根除率为83.3%(意向分析,ITT,符合方案分析,PP),B组H.pylori根除率为91.8%(ITT),94.9%(PP);A组疼痛缓解率为81.3%(ITT,PP),B组疼痛缓解率为93.5%(ITT),95.6%(PP)。按PP群组分析B组H.pylori根除率及疼痛缓解率明显高于A组,按ITT组群分析,两组方案H.pylori根除率及疼痛缓解率无明显差异。结论:含大剂量雷贝拉唑的含铋四联10 d疗法较标准剂量雷贝拉唑四联疗法可以获得更高的H.pylori根除率及疼痛缓解率。Objective： To compare the efficacy and tolerability of a 10-day double-dose rabeprazole-based quadruple regimen composed of bismuth with a standard-dose rabeprazole quadruple regimen in eradicating Helicobacter pylori infection and relieving symptoms. Methods： Patients with H. pylori-positive duodenal ulcer disease as well as gastritis were randomly assigned to receive rabeprazole-based quadruple regimens at different doses： bismuth potassium citrate 220 mg, clarithromycin 500 rag, amoxicillin 1 000 rag, plus either rabeprazole 10 mg （Group A） or 20 mg （Group B）, all twice daily for 10 days. H. pylori status was determined by urease test, and 13C-urea breath test. Eradication of H. pylori and symptomatic relief status were also determined. Results： A total of 121 patients were included into this clinical trial..Group A was composed of 60 patients and Group B was composed of 61 patients. Intention-to-treat eradication rates of Group A and Group B were 83.3% and 91.8% respectively, and per protocol eradication rates of Group A and Group B were 83.3% and 94.9% respectively. Intention-to-treat pain relieving rates of Group A and Group B were 81.3% and 93.5% respectively and per protocol pain relieving rates of Group A and Group B were 81.3% and 95.6% respectively. According to per protocol analysis, H. pylori eradication rate and pain relieving rate of Group B were significantly higher than those of Group A, and based on Intention-to-treat analysis, there was no significantly difference in HP eradication rate and pain relieving rate between both groups. Conclusion： The 10-day double-dose rabeprazole containing bismuth quadruple regimen achieved both better eradication rate and pain relieving rate than standard-dose rabeprazole quadruple regimens for H. pylori eradication.

关 键 词：幽门螺杆菌 四联疗法 雷贝拉唑 

分 类 号：R975[医药卫生—药品]