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目的研究序贯疗法与标准三联药物疗法治疗幽门螺杆菌感染的根除率之间的差异。方法根据胃镜检查及尿素酶试验筛选幽门螺旋杆菌感染的十二指肠溃疡穿孔患者61例,随机分成两组,分别接受标准的三联药物疗法或序贯疗法。标准三联药物疗法包括奥美拉唑,克拉霉素和阿莫西林,疗程10d。序贯疗法包括奥美拉唑和阿莫西林或前5d口服奥美拉唑和阿莫西林,后5d改用克拉霉素。2个月后利用胃镜检查评估每个疗程的根除率及不良反应。结果标准三联疗法和序贯疗法的根除率分别为83.3%和90.3%(P=0.473)。序贯疗法的费用较低,两组的不良反应发生率相似。结论序贯疗法和标准三联疗法根除幽门螺旋杆菌的疗效相似,但序贯疗法比较经济可替代标准三联疗法。
Objective To study the difference between sequential therapy and standard triple therapy for the treatment of Helicobacter pylori eradication. Methods According to gastroscopy and urease test, 61 patients with H. pylori-infected duodenal ulcer perforation were randomly divided into two groups, receiving standard triple drug therapy or sequential therapy respectively. Standard triple therapy includes omeprazole, clarithromycin, and amoxicillin for 10 days. Sequential therapies include omeprazole and amoxicillin or oral omeprazole and amoxicillin for the first 5 days, followed by clarithromycin for the next 5 days. Two months later, gastroscopy was used to assess the eradication rate and adverse reactions of each course of treatment. Results The standard eradication rates of triple therapy and sequential therapy were 83.3% and 90.3%, respectively (P = 0.473). Sequential therapy costs are lower, the incidence of adverse reactions in both groups is similar. Conclusions Sequential and standard triple therapy have similar efficacy in eradicating H. pylori, but sequential therapy is an economical alternative to standard triple therapy.