摘要
目的观察不同剂量三联方案7日疗法根除幽门螺杆菌(H.pylori)的疗效。方法收集216例H.pylori阳性的消化性溃疡或慢性胃炎患者,随机分为4组:RCA(小剂量)组、RCM(小剂量)组、RCA组及RCM组分别给予含克拉霉素0.25及0.5的三联方案治疗7 d,各组慢性胃炎患者疗程结束后停用所有药物,消化性溃疡患者停用抗生素后继续口服雷贝拉唑4～6周。所有受试者停用抗生素至少4周并停用PPI至少2周后复查14C-UBT。结果①4组H.pylori根除率按ITT分析分别为77.78%、55.56%、83.33%及55.56%,按PP分析分别为82.35%、65.95%、90.00%及68.18%,RCA组H.pylori根除率高于RCA(小剂量)组差异有显著性(P<0.05);②4组患者溃疡愈合情况、症状缓解率及不良反应发生率均差异无显著性(P>0.05);③RCA(小剂量)组、RCM(小剂量)组较RCA组及RM组方案治疗成本及C/E比值低,RCA(小剂量)组和RCA组三联7日疗效优于RCM(小剂量)组及RCM组,能有效根除H.pylor(iP<0.05),RCA组优于RCA(小剂量)组(P<0.05)。结论 RCA(小剂量)组和RCA组三联7日疗法均能有效根除H.pylori,且副反应小,病人依从性好,且RCA(小剂量)组及RCA组有望成为一线H.pylori根除方案,尤其是RCA组。
【Objective】 To observe the effect of 7-day triple therapy with different dose for the eradication of helicobacter pylori infection.【Method】 216 H.pylori positive patients with peptic ulcer or chronic gastritis were selected and randomly divided into four groups： RCA low-dose group and RCA routine-dose group,RCM low-dose group and RCM routine-dose group were treated with different clarithromycin-based triple therapy for 7 days,respectively;The patients with nonulcer dyspepsia in four groups discontinued all drugs after the course of treatment,while the patients with peptic ulcer continued to receive Rabeprazole for another 3～7 weeks after stopped antibiotics.After completion of H.pylori therapy at least four weeks later and after withdrawal of PPI at least two weeks later,H.pylori status was tested by the 14C-urea breath test（14C-UBT）.【Results】 ①The rates of H.pylori eradication in RCA low-dose group and RCA routine-dose group were 77.78% and 83.33% respectively by intention to treat analysis,were 82.35% and 86.53% respectively by per protocol analysis（the differences had no statistical significance,P 〉0.05）.The rates were higher than RCM low-dose group and RCM routine-dose group（P 〈0.05）.The rate of RCA routine-dose were higher than RCM low-dose group（P 〈0.05）.②The peptic ulcer healing rates and the incidence of adverse reactions were not different significantly（P 〉0.05）.③The cost effectiveness analysis showed that the cost and C/E value of RCM low-dose group and RCA low-dose group regimen were lower than RCM routine-dose group and RCA routine-dose group.【Conclusion】 RCA low-dose group triple therapy and RCA routine-dose group are effective therapeutic regimens for helicobacter pylori infection with the advantages of excellent compliance of patients,mild side-effects,RCA low-dose group and RCA group can be recommended as first-line therapy regimens of eradicating H.pylori in developing region,particularly,RCA group was most effective.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2012年第13期101-104,共4页
China Journal of Modern Medicine
基金
广西壮族自治区卫生厅自筹项目(No:Z2008301)
关键词
幽门螺杆菌
根除治疗
雷贝拉唑
克拉霉素
helicobacter pylori
eradication therapy
rabeprazole
clarithromycin
