摘要
目的:比较铋剂四联组、10 d改良序贯组、14 d改良序贯组补救根除幽门螺旋杆菌(Helicobacter pylori,H.pylori)感染的效果差异.方法:将首次铋剂四联疗法根除H.pylori失败的195例慢性胃炎、消化性溃疡患者,随机分为铋剂四联组、10 d改良序贯组、14 d改良序贯组,每组65例.A组(铋剂四联组)给予雷贝拉唑、阿莫西林、左氧氟沙星、胶体果胶铋;B组(10 d改良序贯组)前5 d予雷贝拉唑、阿莫西林,后5 d予雷贝拉唑、左氧氟沙星、呋喃唑酮;C组(14 d改良序贯组)前7 d予雷贝拉唑、阿莫西林,后7 d予雷贝拉唑、左氧氟沙星、呋喃唑酮.所有患者在疗程结束停药4 wk后行^(14)C尿素呼气试验.记录3组患者药物不良反应.结果:A、B、C组根除率分别为75.4%、89.2%、95.4%,同A组相比,B组根除率(χ~2=0.039,P<0.05)和C组根除率(χ~2=0.001,P<0.05)明显提高,差异有统计学意义.B组高于C组,差异无统计学意义(χ~2=0.188,P>0.05).A组不良反应率为27.7%、B组不良反应率26.2%、C组不良反应率29.2%,差异无统计学意义(P>0.05).结论:对于H.pylori补救治疗,改良序贯疗法疗效更好,且不良反应低,推荐14 d改良序贯疗法作为首选方案之一.
AIM： To compare the efficacy of bismuth- based quadruple therapy, 10-day improvedsequential therapy, and 14-day improved sequential therapy in rescue therapy of Helicobacter pylori （H. pylori） infection. METHODS： One hundred and ninety-five patients with chronic gastritis or peptic ulcer who failed first-line eradication of H. pylori were randomly divided into a bismuth- based quadruple therapy （group A）, a 10-day improved sequential therapy group （group B）, and a 14-day improved sequential therapy group （group C）, with 65 cases in each group. Group A was given rabeprazole, amoxicillin, levofloxacin, and colloidal bismuth pectin capsules. Group B was given rabeprazole and amoxicillin for the first 5 days, and then rabeprazole, levofloxacin, and furazolidone for another 5 days. Group C was given rabeprazole and amoxicillin for the first 7 days, and then rabeprazole, levofloxacin and furazolidone for another 7 days. At 4 weeks after the end of the treatment, all patients underwent the 14C-urea breath test. Adverse drug reactions were recorded in the three groups. RESULTS： The eradication rates were significantly higher in groups B and C than in group A （95.4%, 89.2% vs 75.4%, χ2= 0.039, 0.001, P 〈 0.05 for both）, and in group B than in group C （χ2= 0.188, P 〉 0.05）. There was no significant difference in drug reactions among the three groups （χ2= 0.84, 0.85, 0.70, P 〉 0.05） CONCLUSION： Modified sequential therapy is more effective and associated with fewer adverse reactions in the rescue treatment of H. pylori infection than bismuth-based quadruple therapy. The 14-day modified sequentialtherapy is a preferred option.
出处
《世界华人消化杂志》
CAS
2015年第36期5894-5897,共4页
World Chinese Journal of Digestology
关键词
幽门螺杆菌感染
铋剂四联
序贯疗法
补救治疗
Helicobacterpylori infection
Bismuth-based quadruple
Sequential therapy
Rescuetherapy
