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目的探讨胶体果胶铋、雷贝拉唑、阿莫西林和克拉霉素四联疗法与不含铋剂的三联疗法根除幽门螺杆菌(helicobacterpylori,Hp)感染的疗效。方法将2012年1月—2013年1月消化内科门诊收治的142例Hp感染患者采用数字表法随机分为两组,每组各71例,患者治疗时均戒烟、禁酒,且避免进食刺激性食物;观察组采取胶体果胶铋、雷贝拉唑、阿莫西林和克拉霉素四联疗法,即胶体果胶铋150 mg/次,3次/d+雷贝拉唑20 mg/次,1次/d+阿莫西林1.0 g/次,2次/d+克拉霉素0.5 g/次,2次/d。对照组采取不含铋剂的三联疗法,即雷贝拉唑20 mg/次,1次/d+阿莫西林1.0 g/次,2次/d+克拉霉素0.5 g/次,2次/d。两组患者均治疗1周,停药4周后复查14C尿素呼气试验或快速尿素酶试验,阴性者即为Hp根除,比较两组Hp根除率及不良反应发生情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组治疗后Hp根除率为94.37%,显著高于对照组的77.46%,且两组比较差异有统计学意义(P<0.05);两组治疗后不良反应发生率比较差异无统计学意义(P﹥0.05)。结论胶体果胶铋、雷贝拉唑、阿莫西林、克拉霉素四联疗法治疗Hp疗效优于不含铋剂的三联疗法,且不良反应小,具有较好的临床应用价值。
Objective To investigate the efficacy of colloidal bismuth pectate, rabeprazole, amoxicillin and clarithromycin quadruple therapy combined with bismuth-free triple therapy in the eradication of helicobacter pylori (Hp) infection. Methods A total of 142 cases of Hp infection admitted to the Department of Gastroenterology from January 2012 to January 2013 were randomly divided into two groups (n = 71 in each group). All patients stopped smoking and alcohol and avoided eating irritation Food; observation group to take colloidal bismuth pectin, rabeprazole, amoxicillin and clarithromycin quadruple therapy, colloidal bismuth pectin 150 mg / time, 3 times / d + rabeprazole 20 mg / time, 1 Times / d + amoxicillin 1.0 g / time, 2 times / d + clarithromycin 0.5 g / time, 2 times / d. The control group received bismuth-free triple therapy with rabeprazole 20 mg once daily, amoxicillin 1.0 g twice daily, clarithromycin 0.5 g once daily, and vehicle twice daily. Two groups of patients were treated for 1 week, 4 weeks after discontinuation of 14C urea breath test or rapid urease test, the negative is Hp eradication, Hp eradication rate and adverse reactions were compared between the two groups. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The Hp eradication rate in the observation group was 94.37%, significantly higher than that in the control group (77.46%), and there was significant difference between the two groups (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion The colloidal bismuth pectin, rabeprazole, amoxicillin, clarithromycin quadruple therapy Hp efficacy than bismuth-free triple therapy, and adverse reactions, has good clinical value.