伏诺拉生在抗幽门螺杆菌治疗中的疗效研究  

Study on the efficacy of vonoprazan in the treatment of helicobacter pylori

作　　者：冉露 刘露路[1] 王珏[1] 郑燕 古赛[1] RAN Lu;LIU Lulu;WANG Yu;ZHENG Yan;GU Sai(Department of Gastroenterology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院消化内科,重庆400016

出　　处：《现代医药卫生》2023年第20期3437-3441,3448,共6页Journal of Modern Medicine & Health

摘　　要：目的 观察伏诺拉生(VNP)与奥美拉唑治疗幽门螺杆菌(Hp)的疗效及安全性。方法 将2021年8月至2022年5月该院消化内科收治的经胃镜检查证实为Hp感染的慢性胃炎患者240例应用STATA9.0统计软件生成的随机数字序列随机分为质子泵抑制剂(PPI)14 d组、VNP 14 d组和VNP 7 d组,每组80例。PPI 14 d组、VNP 14 d组、VNP 7 d组患者中分别因失访脱落2、3、4例,PPI 14 d组、VNP 7 d组患者中均因未规律服药脱落2例,脱落率均为5.4%。PPI 14 d组、VNP 14 d组、VNP 7 d组最终分别纳入患者76、77、74例。3组患者均予以抗Hp治疗,在接受枸橼酸铋钾颗粒2.0 g,每天2次;阿莫西林胶囊500 mg,每天2次;克拉霉素片500 mg,每天2次。VNP 7 d组应用VNP 20 mg,每天2次,连用7 d;PPI 14 d应用奥美拉唑20 mg,每天2次,连用14 d;VNP 20 mg,每天2次,连用14 d。治疗结束停药4~6周后空腹行碳13尿素呼气试验复查Hp。比较3组患者Hp根除率及不良反应发生率。结果 PPI 14 d组、VNP 14 d组、VNP 7 d组患者意向性治疗分析的根除率分别为80.0%、83.8%、76.2%,研究方案分析的根除率分别为84.2%、87.0%、82.4%。3组患者Hp根除率比较,差异无统计学意义(P>0.05)。所有不良事件均为轻度,3组患者不良事件发生率比较,差异无统计学意义(P>0.05)。结论 VNP 7 d方案耐受性良好,其疗效和安全性与PPI 14 d方案和VNP 14 d方案相似。因此,VNP 7 d方案或可作为根除Hp的推荐方案之一。Objective To observe the efficacy and safety of vonoprazan(VNP)and omeprazole in the treatment of helicobacter pylori(Hp).Methods A total of 240 patients with chronic gastritis confirmed by gastroscopy as Hp infection admitted to Department of Gastroenterology of this hospital from August 2021 to May 2022 were divided into the proton pump inhibitor(PPI)14 d group,VNP 14 d group and the VNP 7 d group by the random number sequence generated by STATA 9.0 statistical software,with 80 cases in each group.There were two,three and four cases of shedding in the PPI 14 d group,VNP 14 d group and VNP 7 d group due to missing follow-up,respectively,and two and two cases of shedding in the PPI 14 d group and VNP 7 d group due to irregular medication,respectively,with a shedding rate of 5.4%.A total of 76,77,and 74 patients in the PPI 14 d group,VNP 14 d group and VNP 7 d group were finally included.All patients in the three groups were given anti-Hp treatment,they received 2.0 g bismuth potassium citrate granule,twice a day+amoxicillin capsule 500 mg,twice a day+clarithromycin tablet 500 mg,twice a day,and a combination of 7 d VNP 20 mg twice a day(the VNP 7 d group),14 d omeprazole 20 mg twice a day(the PPI 14 d group),or VNP 20 mg twice a day(the VNP 14 d group).Four to six weeks after the end of treatment,fasting carbon 13 urea breath test was performed to re-examine Hp.The eradication rate of Hp and the incidence of adverse reactions in the three groups were compared.Results The eradication rates of intentional treatment analysis of the PPI 14 d group,VNP 14 d group and VNP 7 d group were 80.0%,83.8%and 76.2%,respectively,and the eradication rates of experimental protocol analysis were 84.2%,87.0%and 82.4%,respectively.There was no significant difference in Hp clearance among the three groups(P>0.05).All adverse events were mild,and there was no significant difference in the incidence of adverse events among the three groups(P>0.05).Conclusion The VNP 7 d regimen is well tolerated,and its efficacy and safety are similar

关 键 词：幽门螺杆菌 伏诺拉生 四联方案 根除治疗 

分 类 号：R573.3[医药卫生—消化系统]