含阿莫西林的四联方案根除幽门螺杆菌的疗效及安全性初步评价  

Preliminary Evaluation of Efficacy and Safety of Amoxicillin-Containing Quadruple Regimen for the Eradication of Helicobacter Pylori

作　　者：倪益玲 陈冰心[1] 冯璜[1] 陈卫昌[1] NI Yi-ling;CHEN Bing-xin;FENG Huang;CHEN Wei-chang(Department of Gastroenterology,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院消化内科,江苏苏州215006

出　　处：《中国血液流变学杂志》2020年第2期184-186,193,共4页Chinese Journal of Hemorheology

摘　　要：目的 初步评价含阿莫西林的四联方案根除幽门螺杆菌的疗效以及安全性.方法 纳入幽门螺杆菌感染的患者共159例,患者均来自苏州大学附属第一医院幽门螺杆菌专病门诊.159例患者被随机分配到A组(含阿莫西林)和B组(不含阿莫西林).两组均采用14 d四联方案,即艾司奥美拉唑镁肠溶片20 mg bid+枸橼酸铋钾胶囊220 mg bid+2种抗生素,A组的抗生素组合为阿莫西林胶囊1 g bid+克拉霉素缓释片500 mg bid,B组的抗生素组合为克拉霉素缓释片500 mg bid+替硝唑片500 mg bid.治疗结束后4周复查尿素呼气试验,比较两组的根除率和不良反应发生率.结果 在ITT分析中,A组的根除率为87.2%,B组的根除率为56.8%,两组间的根除率差异具有统计学意义(P<0.05).在PP分析中,A组的根除率为93.2%,B组的根除率为62.2%,两组间的根除率差异具有统计学意义(P<0.05).主要的不良反应有皮疹、恶心呕吐、腹痛腹泻和头晕头痛等,两组的不良反应发生率差异无统计学意义(P=0.746).结论 含阿莫西林的四联方案根除幽门螺杆菌更有优势,值得进一步推广应用.Objective To evaluate the efficacy and safety of amoxicillin-containing quadruple regimen for the eradication of Helicobacter pylori.Methods A total of 159 patients with Helicobacter pylori infection were included,all of whom were from the Helicobacter pylori special clinic of the First Affiliated Hospital of Soochow University.159 patients were randomly assigned to either group A(including amoxicillin)or group B(excluding amoxicillin).Both groups adopted a 14-day quadruple regimen,namely esomeprazole magnesium enteric-coated tablet 20 mg bid+bismuth potassium citrate capsule 220 mg bid+2 antibiotics.The antibiotic combination of group A was amoxicillin capsule 1 g bid+clarithromycin sustained-release tablets 500 mg bid,while the antibiotic combination of group B was clarithromycin sustained-release tablets 500 mg bid+tinidazole tablets 500 mg bid.Urea breath test was performed 4 weeks after treatment,and the eradication rate and adverse reaction rate of the two groups were compared.Results In ITT analysis,the eradication rate was 87.2%in group A and 56.8%in group B,and the difference between the two groups was statistically significant(P<0.05).In PP analysis,the eradication rate of group A was 93.2%,while that of group B was 62.2%.The difference of eradication rate between the two groups was statistically significant(P<0.05).The main adverse reactions were rash,nausea and vomiting,abdominal pain and diarrhea,dizziness and headache,etc.,and there was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.746).Conclusion The quadruple therapy containing amoxicillin is more advantageous in the eradication of Helicobacter pylori and is worthy of further popularization and application.

关 键 词：幽门螺杆菌 阿莫西林 根除率 不良反应 

分 类 号：R57[医药卫生—消化系统]