摘要
目的 :观察奥美拉唑、阿莫西林、呋喃唑酮短程三联疗法作为二线方案根除幽门螺杆菌 (Helicobacterpylori,HP)的疗效和安全性。方法 :16 3例经以质子泵抑制剂为基础的三联疗法根除失败或根除后复发的HP感染病人 ,随机分为A、B、C 3组 ,A组 (n =5 5 ,男性 42 ,女性 13,年龄 6 3± 13岁 )予以奥美拉唑 (O) 2 0mg、阿莫西林 (A) 10 0 0mg、呋喃唑酮 (F) 10 0mg ,bid ,疗程 7d(简称OAF方案 ) ;B组 (n =5 4,男性 44,女性 10 ,年龄 6 1± 13岁 )予以奥美拉唑 2 0mg、德诺(C) 2 40mg、甲硝唑 (M ) 40 0mg ,bid ,四环素 (T) 5 0 0mg ,qid ,疗程 7d(简称OCMT方案 ) ;C组 (n =5 4男性 43,女性 11,年龄 6 2± 17)予以奥美拉唑 2 0mg、德诺 2 40mg、甲硝唑 40 0mg、阿莫西林 10 0 0mg ,bid ,疗程 7d(简称OCMA方案 )。抗HP治疗结束 1月后 ,全部做13 C 尿素呼气试验。结果 :3组各失访 1例 ,B组因药物不良反应 (ADR)退出 2例 ,C组因ADR退出 1例。A、B、C 3组的HP根除率 :按方案 (PP)分析分别为 87.0 %( 4 7/ 5 4)、82 .4%( 4 2 / 5 1)和 80 .8%( 4 2 / 5 2 ) ,按意图治疗 (ITT)分析分别为 85 .5 %( 4 7/ 5 5 )、77.8%( 4 2 / 5 4)和 77.8%( 4 2 / 5 4) ,P均 >0 .0 5。A、B、C 3组的ADR发生率分别为 5 .5 6 %( 3/ 5 4)。
Purpose: To determine efficacy and safety of short-term triple therapy with omeprazole,amoxicillin and furazolidone as second-line regimen for eradication of Helicobacter pylori(HP). Methods: A total 163 patients who have failed eradication after proton pump inhibitor(PPI)-based triple therapy or have relapsed after eradication, were randomly divided into 3 groups. Group A (n=55,M42,F13, age 63±13 a) were treated for 1 week with omeprazole(Ome) 20 mg, amoxicillin(Amo) 1 000 mg and furazolidone(Fur) 100 mg, bid(regimen OAF). Group B (n=54,M44,F10, age 61±13 a) were treated for 1 week with Ome 20 mg, colloidal bismuthi subcitras(CBS) 240 mg and metronidazole(Met) 400 mg, bid, tetracycline 500 mg, qid(regimen OCMT). Group C (n=54,M43,F11,age 62±17 a) were treated for 1 week with Ome 20 mg, CBS 240 mg, Met 400 mg, and Amo 1 000 mg, bid(regimen OCMA). One month after anti-HP therapy, the 13 C-urea breath test was performed in the patients who completed entire course. Results: One patient were lost to follow up in Group A, B and C, respectively. Two patients in Group B and one patient in Group C stopped the treatment because of severe adverse drug reactions (ADR). On the per-protocol analysis, eradication rates of HP were 87.0%(47/54) in Group A, 82.4%(42/51) in Group B and 80.2%(42/52) in Group C(P>0.05). On the intention-to-treat analysis, eradication rates of HP were 85.5%(47/55) in Group A and 77.8%(42/54) in Group B and Group C, respectively(P>0.05). The occurrence of ADR in Group A, B, C were 5.56%(3/54), 22.64%(12/53) and 11.32%(6/53), respectively, the Group A was fewer than Group B(P<0.01). Conclusions: OFA as second-line regimen for eradication of HP is highly effective, as quadruple therapies(OCMT and OCMA), and OFA is a novel optimal second-line regimen because of fewer ADR and well tolerated.
出处
《临床消化病杂志》
2002年第2期72-74,共3页
Chinese Journal of Clinical Gastroenterology
关键词
幽门螺杆菌
感染
三联疗法
二线方案
Hlicobacter pylori Infection Eradication Triple therapy second-line regimen
