论文部分内容阅读
目的探讨改良序贯疗法和四联疗法补救根除幽门螺杆菌(Hp)的有效性和安全性。方法经标准三联疗法根除Hp失败患者98例随机均分为改良序贯疗法组(A组)和四联疗法组(B组)。A组前7d服奥美拉唑20mg+阿莫西林1000mg+胶体果胶铋150mg,后7d服奥美拉唑20mg+左氧氟沙星500mg+克拉霉素500mg+胶体果胶铋150mg。B组服奥美拉唑20mg+阿莫西林1000mg+克拉霉素500mg+胶体果胶铋150mg,共14d。治疗结束后4周复查13 C-呼气试验。结果共90例患者完成试验。按意向治疗和方案分析,A组总体Hp根除率高于B组(81.6%vs.67.3%和85.1%vs.76.7%)(P<0.05);按方案分析,A组在慢性胃炎和消化性溃疡患者中的Hp根除率均高于B组(85.2%vs.78.3%和85.0%vs.75.0%)(P<0.05)。两组间不良反应发生率相仿(10.2%vs.16.3%)(P>0.05)。结论对Hp根除失败的患者,改良序贯疗法可作为安全、有效的补救治疗方案。
Objective To investigate the effectiveness and safety of modified sequential therapy and quadruple therapy in the eradication of Helicobacter pylori (Hp). Methods Ninety-eight patients with failed Hp eradication by standard triple therapy were randomly assigned to modified sequential therapy (group A) and quadruple therapy (group B). A group of 7 days before serving omeprazole 20mg + amoxicillin 1000mg + colloidal bismuth pectin 150mg, after 7d omeprazole 20mg + levofloxacin 500mg + clarithromycin 500mg + colloidal bismuth pectin 150mg. Group B omeprazole 20mg + amoxicillin 1000mg + clarithromycin 500mg + colloidal bismuth pectin 150mg, a total of 14d. Four weeks after the end of the treatment review 13 C-breath test. Results A total of 90 patients completed the trial. According to the intent-to-treat and protocol analysis, the overall Hp eradication rate in group A was higher than that in group B (81.6% vs.67.3% vs 85.1% vs.76.7%, P <0.05) Hp eradication rates in ulcer patients were higher than those in group B (85.2% vs 78.3% and 85.0% vs. 75.0%, respectively) (P <0.05). Adverse reactions between the two groups were similar (10.2% vs.16.3%) (P> 0.05). Conclusion Improved sequential therapy can be used as a safe and effective remedy for patients with failed Hp eradication.