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[目的]观察和比较序贯疗法与标准三联疗法在根除幽门螺杆菌(Hp)的临床疗效和安全性。[方法]选取160例慢性胃炎或消化性溃疡患者为研究对象,将其随机分为观察组和对照组,对照组患者应用标准三联疗法(奥美拉唑20.0mg bid+克拉霉素0.5g bid+阿莫西林1.0g bid,7d),观察组患者应用序贯疗法(首先给予奥美拉唑20.0mg bid+阿莫西林1.0g bid,5d;而后给予奥美拉唑20.0mg bid+克拉霉素0.5g bid+左氧氟沙星0.5g bid,5d)。对2组患者的临床疗效、Hp清除率、不良反应发生率进行观察和比较。[结果]2组的各项疗效评价结果及临床有效率比较,均差异无统计学意义(P>0.05);观察组、对照组的Hp清除率分别为90.0%、68.8%,观察组Hp清除率显著高于对照组(χ2=11.033,P<0.01);观察组、对照组患者不良反应的总发生率分别为8.8%、5.0%,2组患者不良反应的总发生率比较,差异无统计学意义(P>0.05)。[结论]在根除Hp治疗中应用序贯疗法,具有与标准三联疗法相当的疗效和安全性,而且可提高Hp清除率。
[Objective] To observe and compare the clinical efficacy and safety of sequential therapy and standard triple therapy in the eradication of Helicobacter pylori (Hp). [Method] A total of 160 patients with chronic gastritis or peptic ulcer were selected as study subjects and randomly divided into observation group and control group. Patients in control group were treated with standard triple therapy (omeprazole 20.0mg bid + clarithromycin 0.5g bid + The patients in the observation group were treated with sequential therapy (first, omeprazole 20.0 mg bid + amoxicillin 1.0 g bid for 5 days; then omeprazole 20.0 mg bid + clarithromycin 0.5 g bid + Levofloxacin 0.5g bid, 5d). The clinical efficacy, Hp clearance and the incidence of adverse reactions in the two groups were observed and compared. [Results] There was no significant difference between the two groups (P> 0.05). The Hp clearance rates in observation group and control group were 90.0% and 68.8% respectively. Hp clearance in observation group (Χ2 = 11.033, P <0.01). The overall incidence of adverse reactions in the observation group and the control group were 8.8% and 5.0% respectively. There was no statistical difference in the overall incidence of adverse reactions between the two groups Significance (P> 0.05). [Conclusion] Sequential therapy in the treatment of eradication Hp has the same curative effect and safety as the standard triple therapy, but also increases the Hp clearance rate.