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目的:评价含左氧氟沙星的三联方案治疗幽门螺杆菌的有效性和安全性及不同疗程的疗效。方法:将幽门螺旋杆菌(Helicobacter pylori,H pylori)阳性的患者263例随机分为克拉霉素治疗组和阿莫西林治疗组,各组按不同疗程分为5、7、10、14d亚组,两组联合的抗菌药均含左氧氟沙星,抑酸剂选用雷贝拉唑。各组在治疗前1周内和治疗后4~8周分别检测H pylori感染情况。结果:含左氧氟沙星的三联方案H pylori根除率为81.0%,克拉霉素治疗组H pylori根除率与阿莫西林治疗组比较无统计学差异(P>0.05),随着疗程的增加根除率也增加,7、10、14d亚组要明显高于5d亚组,但10、14d亚组之间无统计学意义(P>0.05);两组随着疗程的增加不良反应的发生率均增加,但克拉霉素组总的发生率要略高于阿莫西林组;在临床症状缓解方面,两组之间无统计学意义(P>0.05),但各组随着疗程的增加缓解率也增加,但10d与14d亚组的临床症状缓解率之间无统计学意义(P>0.05)。结论:含左氧氟沙星的雷贝拉唑联合克拉霉素或阿莫西林是安全有效的幽门螺杆菌根除方案,7、10、14d疗程均可获得好的疗效,综合根除率、不良反应发生率和临床症状缓解率,10d疗程最佳。
Objective: To evaluate the effectiveness and safety of the triple regimen containing levofloxacin in the treatment of Helicobacter pylori and the efficacy of different courses. Methods: 263 patients with Helicobacter pylori (H pylori) positive were randomly divided into clarithromycin treatment group and amoxicillin treatment group. Each group was divided into 5, 7, 10 and 14 d subgroups according to different courses of treatment. Levofloxacin was included in both combinations of antibacterials and rabeprazole was selected as antacid. H pylori infection was detected within 1 week before treatment and 4 to 8 weeks after treatment. Results: The eradication rate of H pylori in the triple regimen with levofloxacin was 81.0%. There was no significant difference between the two groups (P> 0.05) , 7,10,14d subgroups were significantly higher than those of 5d subgroups, but there was no significant difference between 10 and 14d subgroups (P> 0.05). The incidence of adverse reactions increased with the increase of treatment course in both groups The overall incidence of clarithromycin group was slightly higher than the amoxicillin group; in terms of clinical symptoms, there was no significant difference between the two groups (P> 0.05), but the remission rate of each group increased with the course of treatment There was no significant difference between the 10d and 14d subgroups in the rate of clinical symptoms (P> 0.05). Conclusion: Rabeprazole with levofloxacin combined with clarithromycin or amoxicillin is safe and effective in the treatment of Helicobacter pylori eradication. Good therapeutic effect can be obtained after 7, 10 and 14 days of treatment. The total eradication rate, the incidence of adverse reactions and clinical Symptoms remission rate, 10d best course of treatment.