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目的:进一步提高内科医生对幽门螺杆菌(HP)根除治疗的认识。方法:调查1995～ 1998年4年间治疗HP的处方共计1640张,观察不同年代不合理及合理治疗HP的用药状况,分析合理和不合理治疗方案的医生分布,及两种方案随年代不同的变化情况。同时问卷调查100名医生对HP“根除”或“治愈”概念的了解以间接分析HP治疗后的处理情况。结果:不合理处方480张(29.3% ),其中主要是单一用药,不含铋剂(Bi)或质子泵抑制剂(PPI)的两联疗法或三联疗法。不合理处方中进修非消化科医生(jf)、进修消化科医生(jx)、本院非消化科医生(bf)及本院消化科医生(bx)分别占42.7% 、31.5% 、21.5% 及4 .3% 。bx与前三者比均有显著性差异P<0.05或P<0.01。结论:目前广大基层医生对“根除HP”的认识不足,治疗方法不合理,应提高对合理治疗的方案、疗程及适应证的认识,从而提高治疗质量,减少药物副作用和耐药性的发生。
Objective: To further enhance the understanding of physicians on Helicobacter pylori (HP) eradication therapy. Methods: A total of 1640 prescriptions for treating HP during the four years from 1995 to 1998 were investigated. The status of irrational and rational treatment of HP in different ages was observed. The distribution of physicians with reasonable and unreasonable treatment regimens was analyzed and the changes of the two schemes with age were analyzed Happening. At the same time, a questionnaire survey of 100 doctors on HP “eradication” or “cure” to understand the concept of indirect treatment of HP after treatment. Results: There were 480 unreasonable prescriptions (29.3%), which were mainly single-drug combination therapy or triple therapy without bismuth (Bi) or proton pump inhibitor (PPI). (Jf), gi (jx), bf and bx accounted for 42.7%, 31.5% and 21.5% respectively of the unreasonable prescriptions and 4 .3%. bx and the former three were significantly different P <0.05 or P <0.01. Conclusion: At present, most grassroots doctors do not know enough about “eradicating HP” and their treatment methods are not reasonable. They should raise their understanding of the scheme, course of treatment and indications for rational treatment so as to improve the quality of treatment and reduce the side effects and drug resistance of the drug.