含多西环素和呋喃唑酮的四联疗法对幽门螺杆菌感染初治的临床疗效  

Efficacy and safety of doxycycline and furazolidone-based quadruple therapy as first-line treatment for Helicobacter pylori infection

作　　者：李生[1] 鲁小平[1] 丁百静[1] 汪再炎 

机构地区：[1]皖南医学院附属芜湖市第二人民医院消化内科,安徽省芜湖市241000

出　　处：《世界华人消化杂志》2015年第26期4279-4283,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨含多西环素和呋喃唑酮的四联疗法根除幽门螺杆菌(Helicobacter pylori,H.pylori)的疗效和不良反应,并对成本一效果进行分析.方法:纳入129例H.pylori感染患者,随机分为治疗组和对照组:治疗组给予雷贝拉唑、多西环素、呋喃唑酮、构橼酸铋钾治疗.对照组给予雷贝拉唑、阿莫西林、左氧氟沙星、构橼酸铋钾治疗;观察各组H.pylori根除率、药物不良反应发生率及成本-效果比.结果:与对照组相比,治疗组方案集分析(per-protoc,PP)和意向性分析(intent-to-treat,ITT)H.pylori根除率均显著升高(PP:91.7%vs 76.7%,P<0.05;ITT:85.9%vs 70.8%,P<0.05),而不良反应发生率无明显差异(14.5%vs 17.5%,P>0.05).对成本-效果分析显示成本及C/E值治疗组<对照组.结论:含多西环素和呋喃唑酮的四联疗法根除H.pylori疗效肯定,不良反应小,降低了四联方案的成本,但该方案广泛应用于临床还需进一步大样本的临床研究,其安全性还有待于进一步观察和研究.AIM：To assess the efficacy and safety of doxycycline and furazolidone-based quadruple therapy as first-line treatment for Helicobacter pylori（H.pylori） infection.METHODS：129 patients with H.pylori positive were randomly divided into two groups：therapy group and control group.Therapy group was treated with rabeprazole,doxycycline,furazolidone and bismuth potassium citrate,control group was treated with rabeprazole,amoxicillin,levofloxacin and bismuth potassium citrate.The rate of H.pylori eradication,the incidence of adverse reactions and costeffectiveness ratio were compared between the two groups.RESULTS：The rate of H.pylori eradication in therapy group was significantly higher than that in control group[per-protoc（PP）：91.7%vs 76.7%,P〈0.05;intent-to-treat（ITT）：85.9%vs 70.8%,P〈0.05].The incidence of adverse reactions was no significant difference between therapy group and control group（14.5%vs17.5%,P〉0.05）.The cost-effectiveness analysis showed that the cost and the C/ E value of the treatment group were lower than that in the control group.CONCLUSION：Doxycycline and furazolidonebased quadruple therapy is associated with a high rate of H.pylori eradication and few slight side effects and can reduce the costs of quadruple treatment.

关 键 词：多西环素 呋喃唑酮 四联疗法 幽门螺杆菌 

分 类 号：R57[医药卫生—消化系统]