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主管:陕西省卫生健康委员会
主办:西安心身医学研究所
   西安交通大学第一附属医院
国际标准刊号:ISSN2096—1413
国内统一刊号:CN61—1503/R

三种联合方案对幽门螺杆菌的根除效果比较

吴方雄1,2 ,田秋梅2 ,鲁晓岚1

(1. 西安交通大学医学院第二附属医院消化内科,陕西 西安,710004;2. 西安医学院第一附属医院消化内科, 陕西 西安,710077)

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摘要:

目的 比较三种联合治疗方案对幽门螺杆菌(Hp)根除率的影响,并评估其安全性、患者耐受性。方法 选取在我院就诊的Hp 感染相关胃溃疡、十二指肠溃疡、慢性胃炎患者150 例为研究对象,随机分为三组,每组50 例。A 组给予埃索美拉唑+ 奥硝唑+阿莫西林+荆花胃康胶丸;B 组给予埃索美拉唑+奥硝唑+阿莫西林+枸橼酸铋钾;C 组给予埃索美拉唑+阿莫西林+甲 硝唑,均治疗14 d。停药4 周后复查C-14 尿素呼气试验(14C-UBT),分析三种方案对Hp的根除率及不良反应发生率。结果 145例患者完成全程治疗,共有4例因患者不能坚持治疗而自动退出,1 例失访,A 组1 例,B组3例,C 组1 例。A 组Hp 根 除率为91.84%,B 组Hp 根除率为91.49%,C组Hp根除率为69.39%,A 组与B 组Hp 根除率均高于C 组,差异具有统计学意 义(P<0.05)。B组不良反应总发生率(17.02%)高于A组(4.08%)及C 组(6.12%),差异具有统计学意义(P<0.05)。结论 含荆花胃康胶丸与铋剂的四联疗法对幽门螺杆菌根除率相当,且均优于传统的三联疗法,但是含铋剂组不良反应发生率较高,可 能会影响患者的依从性。

关键词:幽门螺杆菌(Hp);联合治疗方案;Hp 根除率;安全性;耐受性

中图分类号:R573 文献标志码:A文章编号:2096-1413(2017)27-0009-03

    Effect comparison of three combination regimens for the eradication rate of Helicobacter pylori
    WU Fang-xiong 1 , 2 , TIAN Qiu-mei 2, LU Xiao-lan 1
    (1. Department of Gastroenterology, the Second Affiliated Hospital of Xi``an Jiaotong University, Xi``an 710004; 2. Department of Gastroenterology, the First Affiliated Hospital of Xi``an Medical University, Xi``an 710077, China)

    ABSTRACT: Objective To compare the eradication rate of Helicobacter pylori (Hp) of three combination treatment regimens as well as their safety and the patients`` tolerance. Methods A total of 150 patients who diagnosed with Hp infection related diseases including gastric ulcer, duodenal ulcer, and chronic gastritis were selected and randomly divided into three groups, with 50 cases in each group. The group A received esomeprazole + ornidazole + amoxicillin + Jinghua Weikang capsules; the group B was given escomeprazole + ornidazole + amoxicillin + bismuth potassium citrate; the group C received escomeprazole + metronidazole + amoxicillin. The patients in each group were treated for 14 days. Four weeks after stopping the medication, all the patients were reexamined with the C-14 urea breath test (14C-UBT) to analyze the Hp eradication rates and incidence of adverse reactions among the three groups. Results There were 145 cases finished the whole course of treatment, 4 patients were automatically withdrawn because they were unable to adhere to the treatment and 1 case lost to follow-up (1 case in the group A, 3 cases in the group B and 1 case in the group C). The Hp eradication rates of the group A, B and C were 91.84%, 91.49% and 69.39% respectively. The Hp eradication rates in the group A and group B were obviously higher than that in the group C (P<0.05). The incidences rate of adverse reaction in the group B (17.02%) was significantly higher than that in the group A (4.08%) and group C (6.12%), the differences were statistically significant (P<0.05). Conclusion The Hp eradication rate of the quadruple therapy containing Jinghua Weikang capsules or bismuth potassium citrate is quite well, they were superior to the traditional triple therapy. However, the group containing bismuth potassium citrate has a high incidence of adverse reaction, which may affect patients`` compliance.
    KEYWORDS: Helicobacter pylori (Hp); combination treatment regimens; Hp eradication rate; safety; tolerance

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