伏诺拉生用于幽门螺杆菌根除治疗的临床疗效评价  

Evaluation of Clinical Efficacy of Vonoprazan in the Radical Treatment of Helicobacter Pylori

作　　者：孟雅洁 李仁冬 丁杰雯 闵枫 杜芸 王敏 MENG Yajie;LI Rendong;DING Jiewen;MIN Feng;DU Yun;WANG Min(People's Hospital of Nanchuan District,Chongqing,China 408400)

机构地区：[1]重庆市南川区人民医院,重庆408400

出　　处：《中国药业》2024年第12期101-105,共5页China Pharmaceuticals

基　　金：重庆市卫生健康委医学科研项目[2022WSJK080]。

摘　　要：目的优化幽门螺杆菌(HP)根除治疗的用药方案。方法选取2020年1月至2022年12月在医院体检中心或门诊发现感染HP且胃镜检查无溃疡及其他胃黏膜病变的患者312例,根据根除方案用药的不同分为质子泵抑制剂(PPI)四联组(124例)、伏诺拉生(VPZ)四联组(84例)、VPZ二联组(97例)。PPI四联组予艾司奥美拉唑肠溶胶囊[每次20 mg、每日2次(bid)]+阿莫西林胶囊(每次1 g、bid)+克拉霉素缓释胶囊(每次500 mg、bid)+胶体果胶铋胶囊[每次200 mg、每日3次(tid)];VPZ四联组予富马酸伏诺拉生片(每次20 mg、bid)+阿莫西林胶囊(每次1 g、bid)+克拉霉素缓释胶囊(每次500 mg、bid)+胶体果胶铋胶囊(每次200 mg、tid);VPZ二联组予富马酸伏诺拉生片(每次20 mg、bid)+阿莫西林胶囊(每次1 g、tid)。3组均为口服给药,疗程均为14 d。结果PPI四联组、VPZ四联组及VPZ二联组HP根除成功率分别为85.48%,90.48%,88.66%,组间比较无显著差异(P>0.05),且仅VPZ四联组根除效果满意(根除率>90%);不良事件发生率分别为15.32%,16.67%,7.72%,组间比较有显著差异(P<0.05)。结论在无溃疡及胃黏膜病变人群的HP根除治疗中,含VPZ四联疗法的根除成功率及不良事件发生率均稍高于传统的含PPI四联疗法;VZP(联合高剂量阿莫西林)二联疗法HP根除成功率虽略高于PPI四联疗法,但仍欠满意。未来还需更多临床研究优化,以获得更理想的根除效果。Objective To optimize the medication regimen for radical treatment of Helicobacter pylori(HP).Methods A total of 312 patients diagnosed with HP in hospital physical examination center or outpatient and without ulcer or other gastric mucosal lesion confirmed by gastroscopy from January 2020 to December 2022 were selected.They were divided into the proton pump inhibitor(PPI)-based quadruple therapy group(124 cases),vonoprazan(VPZ)-based quadruple therapy group(84 cases)and VPZ-based dual therapy group(97 cases)based on different eradication regimens.The patients in the PPI-based quadruple therapy group were given Esomeprazole Enteric Capsules[20 mg each time,twice a day(bid)]+Amoxicillin Capsules(1 g each time,bid)+Clarithromycin Sustained Release Capsules(500 mg each time,bid)+Colloidal Bismuth Pectin Capsules[200 mg each time,three times a day(tid)].The patients in the VPZ-based quadruple therapy group were given Vonoprazan Fumarate Tablets(20 mg each time,bid)+Amoxicillin Capsules(1 g each time,bid)+Clarithromycin Sustained Release Capsules(500 mg each time,bid)+Colloidal Bismuth Pectin Capsules(200 mg each time,tid).The patients in the VPZ-based dual therapy group were given Vonoprazan Fumarate Tablets(20 mg each time,bid)+Amoxicillin Capsules(1 g each time,tid).All three groups were treated orally with a course of 14 d.Results The success rates of HP eradication in the PPI-based quadruple therapy group,VPZ-based quadruple therapy group and VPZ-based dual therapy group were 85.48%,90.48%,88.66%respectively,with no significant difference among the groups(P>0.05),and only the VPZ-based quadruple therapy group had a satisfactory eradication effect(eradication rate>90%).The incidence rates of adverse events in the above three groups were 15.32%,16.67%,7.72%respectively,with significant differences among the groups(P<0.05).Conclusion In the radical treatment of HP in the population without ulcer or gastric mucosal lesion,the success rate of HP eradication and incidence of adverse events of VPZ-based quadruple therap

关 键 词：幽门螺杆菌 根除率 伏诺拉生 临床疗效 

分 类 号：R969.3[医药卫生—药理学] R975[医药卫生—药学]