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目的分析总结雷贝拉唑、阿莫西林、克拉霉素、替硝唑组成的10日序贯疗法根除初治失败幽门螺杆菌(Helicobacter pylori,Hp)的疗效。方法将2009年5月2011年5月在消化科门诊及住院经胃镜确诊的胃、十二指肠溃疡患者65例,经标准三联疗法治疗4周后Hp仍阳性的患者随机分为两组,治疗组33例前5d用雷贝拉唑10mg、阿莫西林1.0,每日2次口服,后5d用雷贝拉唑10mg、克拉霉素500mg、替硝唑500mg,每日2次口服;对照组32例用雷贝拉唑10mg、枸橼酸铋钾600mg、呋喃唑酮0.1g、阿莫西林1.0g,每日2次,疗程10d。停药4周后复查Hp。结果治疗组Hp根除率81.8%,对照组75.0%,两组比较无统计学意义(P>0.05)。不良反应率分别为12.1%和34.3%,两组比较有统计学意义(P<0.05)。结论序贯疗法对初治失败Hp根除率高于四联疗法但无统计学意义,不良反应率低于对照组,可作为根除初治失败Hp的一种有效方案。
Objective To summarize the efficacy of sequential therapy of rabeprazole, amoxicillin, clarithromycin and tinidazole in the eradication of initial failed Helicobacter pylori (Hp). Methods Sixty-five patients with gastric and duodenal ulcer diagnosed by gastroscopy in the department of gastroenterology and inpatients from May 2011 to May 2011 were randomly divided into two groups after 4 weeks of standard triple therapy. In the treatment group, the rabbits in the treatment group were treated with rabeprazole 10mg and amoxicillin 1.0 twice daily before the fifth day, and rabeprazole 10mg, clarithromycin 500mg and tinidazole 500mg twice daily after 5 days. Group 32 with rabeprazole 10mg, bismuth potassium citrate 600mg, furazolidone 0.1g, amoxicillin 1.0g, 2 times a day, treatment 10d. 4 weeks after withdrawal review Hp. Results Hp eradication rate was 81.8% in the treatment group and 75.0% in the control group. There was no significant difference between the two groups (P> 0.05). Adverse reaction rates were 12.1% and 34.3%, respectively, with statistical significance (P <0.05). Conclusions The sequential therapy has a higher Hp eradication rate than the quadruple therapy, but the adverse reaction rate is lower than that of the control group, which can be used as an effective eradication therapy for initial Hp failure.