含呋喃唑酮与含克拉霉素四联方案联合双歧杆菌三联活菌肠溶胶囊治疗幽门螺杆菌的应用价值  

The application value of furazolidone and clarithromycin-containing quadruple protocol combined with bifidobacterium triple live bacteria enteric capsule in the treatment of Helicobacter pylori. Cost-effectiveness analysis of the eradication of Helicobacte

作　　者：李常娟[1] 魏俊伟 张金华 李静[1] LI Chang-juan;WEI Jun-wei;ZHANG Jin-hua(Department of Gastroenterology,Handan First Hospital,Handan Hebei 056002,China)

机构地区：[1]邯郸市第一医院消化内科,河北邯郸056002

出　　处：《临床和实验医学杂志》2019年第10期1061-1064,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金(编号:81471704);邯郸市科学技术与发展计划项目(编号:1623208064-7)

摘　　要：目的探究含呋喃唑酮与含克拉霉素四联方案治疗幽门螺杆菌(Hp)感染患者的应用价值,同时探讨四联方案联合双歧杆菌三联活菌肠溶胶囊根除Hp的疗效。方法前瞻性研究,选2016年11月至2017年11月邯郸市第一医院收治的240例Hp感染未经根除治疗的消化性溃疡患者作为研究对象,采用随机数字表法将患者分为A、B、C、D四组,每组各60例。其中A组患者予以埃索美拉唑+枸橼酸铋钾+阿莫西林+克拉霉素治疗; B组患者予以埃索美拉唑+枸橼酸铋钾+阿莫西林+呋喃唑酮治疗; C组患者予以双岐三联活菌胶囊联合埃索美拉唑+枸橼酸铋钾+阿莫西林+克拉霉素治疗; D组患者予以双歧三联活菌胶囊联合埃索美拉唑+枸橼酸铋钾+阿莫西林+呋喃唑酮治疗。观察记录治疗过程中不良反应发生情况与患者症状改善情况,应用完成治疗分析(PP分析)和意向治疗分析(ITT分析)对比四组患者的Hp根治率,应用成本-效果分析对比A、B、C、D 4种方案的增量成本-效果比。结果 A、B、C、D组患者的不良反应发生率分别为10. 2%、12. 5%、6. 9%、8. 5%,差异无统计学意义(P> 0. 05); A、B、C、D组患者的症状改善率分别为86. 4%、92. 9%、89. 7%、93. 2%,差异无统计学意义(P> 0. 05); PP分析显示,A、B、C、D组患者的Hp根治率分别为84. 7%、92. 8%、87. 9%、93. 2%,差异无统计学意义(P> 0. 05),按ITT分析显示,A、B、C、D组患者的Hp根治率分别为83. 3%、86. 7%、85. 0%、91. 7%,差异无统计学意义(P> 0. 05); A、B、C、D组患者的成本-效果比分别为6. 25、3. 51、6. 63、4. 07,增量成本增量效果比(以A组为参照)分别为-25. 1、16. 8、-17. 6。结论 A、B、C、D组患者的Hp根治率均较为理想,且皆具有较好的安全性,但成本-效果分析显示,含呋喃唑酮四联方案治疗成本具有更低的经济成本,患者认可度更高,值得临床推广应用。Objective To investigate the value of furazolidone combined with clarithromycin in the treatment of Helicobacter pylori(Hp)infection,and to explore the efficacy of quadruple protocol combined with Bifidobacterium triple live enteric capsule in eradicating Hp.Methods 240 cases of peptic ulcer patients and chronic gastritis who were treated with Hp infection in Handan First Hospital from November 2016 to November 2017 were given prospective study.Using random number table,the subjects were divided into four groups,group A,B,C,D,with 60 cases in each group.Group A was given Esomeprazole+Bismuth potassium citrate+Amoxicillin+Clarithromycin;group B was treated with Esomeprazole+Bismuth potassium citrate+Amoxicillin+Furazolidone;group C was given bifid triple viable capsules combined with Esomeprazole+Bismuth potassium citrate+Amoxicillin+Clarithromycin;group D was given bifid triple viable capsules combined with Esomeprazole+Bismuth potassium citrate+Amoxicillin+Furazolidone.The occurrence of adverse reactions during treatment and improvement of symptoms were observed and recorded.PP analysis and ITT analysis were used to compare the rate of Hp cure in four groups,and cost-efficacy analysis was performed to compare A,B,C,D four solutions.Results The incidence of adverse reactions in groups A,B,C,and D was10.2%,12.5%,6.9%,and 8.5%respectively,and the difference was not statistically significant(P>0.05);the improvement rates of symptoms in A,B,C,and D groups were 86.4%,92.9%,89.7%,and 93.2%respectively,and the difference was not statistically significant(P>0.05).PP analysis showed that Hp radical cure rate in A,B,C,D four groups were 84.7%,92.8%,87.9%,and 93.2%respectively,and the difference was not statistically significant(P>0.05),ITT analysis showed that Hp radical cure rate in A,B,C,D four groups were 83.3%,86.7%,85.0%,and 91.7%respectively,and the difference was not statistically significant(P>0.05);the cost-effect ratios of A,B,C,and D group were 6.25,3.51,6.63,4.07,respectively,incremental cost-increment ratios(r

关 键 词：幽门螺杆菌 根除 四联方案 呋喃唑酮 克拉霉素 成本-效果分析 

分 类 号：R573[医药卫生—消化系统]