高剂量二联疗法与经典四联疗法根除幽门螺杆菌的疗效对比  

Comparison of efficacy between high-dose dual therapy and classic quadruple therapy in eradicating Helicobacter pylori

作　　者：李明贤[1] 朱振浩 LI Ming-xian;ZHU Zhen-hao(Department of Gastroenterology,Shaoguan Yuebei People's Hospital,Shaoguan 512026,China)

机构地区：[1]韶关市粤北人民医院消化内科,512026

出　　处：《中国现代药物应用》2024年第11期108-110,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨比较根除幽门螺杆菌治疗中应用经典四联疗法和高剂量二联疗法的临床效果。方法选取76例幽门螺杆菌检验阳性患者,通过随机数字表法进行分组,即观察组及对照组,均为38例。对照组予以经典四联疗法(阿莫西林+枸橼酸铋钾+艾司奥美拉唑+克拉霉素),观察组予以高剂量二联疗法(阿莫西林+艾司奥美拉唑)。比较两组幽门螺杆菌根除率、不良反应发生率、血清炎症介质[血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)和白细胞介素-6(IL-6)]水平。结果对照组幽门螺杆菌根除率为89.47%(34/38),观察组幽门螺杆菌根除率为94.74%(36/38),两组幽门螺杆菌根除率比较不存在显著差异(χ^(2)=0.724,P=0.395>0.05)。与对照组的21.05%比较,观察组不良反应发生率5.26%显著较低,差异显著(P<0.05)。治疗前,两组IL-6、IL-8、TNF-α比较无显著差异(P>0.05);治疗后,两组患者IL-6、IL-8、TNF-α水平均较治疗前降低,且观察组IL-6(3.86±1.03)pg/ml、IL-8(0.06±0.05)pg/L、TNF-α(138.62±26.31)ng/ml均低于对照组的(4.69±1.05)pg/ml、(0.11±0.08)pg/L、(351.62±29.62)ng/ml(P<0.05)。结论根除幽门螺杆菌治疗中应用经典四联疗法和高剂量二联疗法的临床效果相当,但高剂量二联疗法可减少药物不良反应,保障患者健康安全,同时利于改善患者血清炎症因子水平,值得推广应用。Objective To explore and compare the clinical effect of high-dose dual therapy and classic quadruple therapy in eradicating Helicobacter pylori.Methods 76 cases of Helicobacter pylori positive patients were selected and randomly divided into an observation group and a control group by random numerical table,each with 38 cases.The control group was treated with classic quadruple therapy(amoxicillin+bismuth potassium citrate+esomeprazole+clarithromycin),while the observation group was treated with high-dose dual therapy(amoxicillin+esomeprazole).The eradication rate of Helicobacter pylori,adverse reaction rate,and the serum inflammatory factor[serum tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and interleukin-6(IL-6)]levels were compared between the two groups.Results The eradication rate of Helicobacter pylori in the control group was 89.47%(34/38),and that in the observation group was 94.74%(36/38).There was no significant difference in eradication rate of Helicobacter pylori between the two groups(χ^(2)=0.724,P=0.395>0.05).Compared with 21.05%in the control group,the incidence of adverse reactions in the observation group was significantly lower(5.26%),and the difference was significant(P<0.05).Before treatment,there were no significant differences in IL-6,IL-8 and TNF-αbetween the two groups(P>0.05).After treatment,the levels of IL-6,IL-8 and TNF-αin both groups were lower than those before treatment;the observation group had IL-6 of(3.86±1.03)pg/ml,IL-8 of(0.06±0.05)pg/L and TNF-αof(138.62±26.31)ng/ml,which were lower than(4.69±1.05)pg/ml,(0.11±0.08)pg/L and(351.62±29.62)ng/ml in the control group(P<0.05).Conclusion The clinical effect of classical quadruple therapy and high-dose dual therapy in Helicobacter pylori eradication is comparable,but high-dose dual therapy can reduce adverse drug reactions,ensure the health and safety of patients,and is beneficial to improving the level of serum inflammatory factors in patients,which is worthy of promotion and application.

关 键 词：阿莫西林 枸橼酸铋钾 艾司奥美拉唑 克拉霉素 幽门螺杆菌 安全性 

分 类 号：R573.1[医药卫生—消化系统]