摘要
目的探讨改良序贯疗法和四联疗法补救根除幽门螺杆菌(Hp)的有效性和安全性。方法经标准三联疗法根除Hp失败患者98例随机均分为改良序贯疗法组(A组)和四联疗法组(B组)。A组前7d服奥美拉唑20mg+阿莫西林1000mg+胶体果胶铋150mg,后7d服奥美拉唑20mg+左氧氟沙星500mg+克拉霉素500mg+胶体果胶铋150mg。B组服奥美拉唑20mg+阿莫西林1000mg+克拉霉素500mg+胶体果胶铋150mg,共14d。治疗结束后4周复查13 C-呼气试验。结果共90例患者完成试验。按意向治疗和方案分析,A组总体Hp根除率高于B组(81.6%vs.67.3%和85.1%vs.76.7%)(P<0.05);按方案分析,A组在慢性胃炎和消化性溃疡患者中的Hp根除率均高于B组(85.2%vs.78.3%和85.0%vs.75.0%)(P<0.05)。两组间不良反应发生率相仿(10.2%vs.16.3%)(P>0.05)。结论对Hp根除失败的患者,改良序贯疗法可作为安全、有效的补救治疗方案。
Objective To investigate the efficacy and safety of modified sequential therapy and quadruple therapy as rescue regimen for Helicobacter pylori（Hp）eradication.Methods A total of 98 patients failed in Hp eradication received randomly rescue regimen of modified sequential therapy（group A,49 cases）or quadruple therapy（group B,49 cases）.The modified sequential therapy was omeprazole 20 mg＋amoxicillin 1000 mg＋colloidal bismuth pectin 150 mg for the first 7 days and omeprazole 20 mg＋levofloxacin 500 mg＋clarithromycin 500 mg＋colloidal bismuth pectin 150 mg for the second 7 days.The quadruple therapy was omeprazole 20 mg＋amoxicillin 1000 mg＋ clarithromycin 500 mg＋colloidal bismuth pectin 150 mg for 14 days.Four weeks after the treatment course,^13 C-urea breath test was performed to assess the Hp eradication rate.Results A total of 90 patients completed the trial.Hp eradication rates by intention-to-treat（ITT）and per-protocol（PP）analysis were higher in group A than those in group B（81.6% vs.67.3% and 85.1% vs.76.7%）（P〈0.05）.Hp eradication rates by PP analysis were higher in group A with chronic gastritis and with peptic ulcer than those in group B（85.2% vs.78.3% and 85.0% vs.75.0%）（P〈0.05）.There was no significant difference in the incidence of adverse effects between two groups（10.2% vs.16.3%）（P〉0.05）.Conclusion The modified sequential therapy can be used as effective and safety rescue therapy for the patients with failure of Hp eradication.
出处
《江苏医药》
CAS
北大核心
2014年第22期2727-2728,2732,共3页
Jiangsu Medical Journal
关键词
序贯疗法
四联疗法
幽门螺杆菌
Sequential therapy
Quadruple therapy
Helicobacter pylori
