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目的比较三联疗法与序贯方案治疗Hp阳性慢性胃炎的Hp根除效果及临床疗效。方法选取2010年7月—2014年12月确诊为Hp阳性慢性胃炎患者76例,简单数字随机法分为三联组和序贯组各38例,三联组采取标准三联疗法(埃索美拉唑20mg Bid+阿莫西林1.0 Bid+克拉霉素0.5 Bid,疗程10 d),序贯组给予序贯方案:前5 d埃索美拉唑(40mg Bid)+阿莫西林(1.0 Bid),后5 d埃索美拉唑(40mg Bid)+替硝唑(0.5 Bid);停药4周后,复查C14呼吸试验,记录Hp根除率,同时观察腹胀、恶心呕吐、腹部灼烧痛等症状消失时间,观察2组治疗效果及疗程间不良反应发生率。结果序贯组Hp根除率及治疗有效率均显著性高于三联组,差异均有统计学意义(P<0.05),腹胀、恶心呕吐、腹部灼烧痛等症状消失时间均明显短于三联组,差异均有统计学意义(P<0.05);两组治疗过程中均无明显不良反应。结论序贯方案治疗Hp阳性慢性胃炎疗效显著,不良反应少,Hp根除率高,值得临床推广应用。
Objective To compare the efficacy of triple therapy and sequential therapy in the treatment of Hp-positive chronic gastritis with Hp eradication and its clinical efficacy. Methods Seventy-six patients with Hp-positive chronic gastritis diagnosed from July 2010 to December 2014 were randomly divided into triple therapy group and sequential therapy group (n = 38). The triple therapy group received standard triple therapy (esomeprazole 20 mg Bid + amoxicillin 1.0 Bid + clarithromycin 0.5 Bid for 10 days), the sequential group was given sequential protocol: 40 mg Bid + 1.0 Bid before 5 d Somelazole (40mg Bid) + tinidazole (0.5 Bid); after stopping for 4 weeks, the C14 respiration test was reviewed and the eradication rate of Hp was recorded. At the same time, the disappearance time of abdominal distension, nausea and vomiting, The effect of treatment and the incidence of adverse reactions between the two groups. Results Sequential group Hp eradication rate and treatment effective rate were significantly higher than the triple group, the difference was statistically significant (P <0.05), bloating, nausea and vomiting, abdomen burning pain and other symptoms disappeared significantly shorter than the triple group , The differences were statistically significant (P <0.05); no adverse reactions in the treatment of both groups. Conclusion Sequential regimens for the treatment of Hp-positive chronic gastritis significant effect, fewer adverse reactions, Hp eradication rate, worthy of clinical application.