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目的观察含左旋氧氟沙星的雷贝拉唑与枸橼酸铋雷尼替丁(RBC,R)三联疗法补救幽门螺杆菌根除失败后的疗效及用药的安全性。方法入选86例患者均为初次治疗失败且停药4周以上,经胃镜和病理检查诊断为消化性溃疡和慢性萎缩性胃炎,快速尿素酶法检测证实为幽门螺杆菌感染,随机分为雷贝拉唑组(46例)和RBC组(40例)。雷贝拉唑组予以雷贝拉唑10 mg,阿莫西林1000 mg,左旋氧氟沙星200 mg,口服,2次/d,连用10 d;RBC组予以RBC350 mg,阿莫西林1000 mg,左旋氧氟沙星200 mg,口服,2次/d,连用10 d。补救结束4周后复查14C-尿素呼气实验,呼气试验阴性者为幽门螺杆菌补救根除成功,阳性为补救治疗失败。结果雷贝拉唑组补救根除率为76.2%,RBC组为73.0%,两组比较差异无统计学意义(P>0.05)。两组均无严重不良反应。结论两种含左氧氟沙星补救方案对Hp根除率均较满意,用药不良反应率相当。
Objective To observe the efficacy and drug safety of levofloxacin combined with ranitidine bismuth citrate (RBC, R) triple therapy in the treatment of helicobacter pylori eradication failure. Methods 86 patients were initially treated failed and discontinued for more than 4 weeks, diagnosed by gastroscopy and pathology as peptic ulcer and chronic atrophic gastritis, rapid urease test confirmed Helicobacter pylori infection, were randomly divided into Rebebe (46 cases) and RBC group (40 cases). Rabeprazole group rabeprazole 10 mg, amoxicillin 1000 mg, levofloxacin 200 mg, oral, 2 times / d, once every 10 days; RBC group to RBC350 mg, amoxicillin 1000 mg, Levofloxacin 200 mg, orally, 2 times / d, once every 10 d. Four weeks after the end of the reexamination 14C-urea breath test, breath test negative for H. pylori remedial eradication was successful, positive for remedial failure. Results The recovery rate of rabeprazole group was 76.2% and that of RBC group was 73.0%. There was no significant difference between the two groups (P> 0.05). No serious adverse reactions in both groups. Conclusion Both of the two regimens with levofloxac remission programs were satisfactory for the eradication rate of Hp, and the rate of adverse reactions was similar.