摘要
背景:近年随着抗菌药物的耐药率逐渐上升,标准三联疗法对幽门螺杆菌(Hp)的根除率不断下降。目的:比较含呋喃唑酮的三联、四联疗法补救治疗Hp阳性慢性胃炎患者的疗效和安全性。方法:选取标准三联疗法(质子泵抑制剂+阿莫西林+克拉霉素或甲硝唑)根除失败的Hp阳性病例80例,将患者随机分为对照组和治疗组。对照组患者给予埃索美拉唑20 mg bid+阿莫西林1 g bid+呋喃唑酮0.1 g bid,疗程10 d;治疗组给予埃索美拉唑20 mg bid+阿莫西林1 g bid+呋喃唑酮0.1 g bid+枸橼酸铋钾220 mg bid,疗程10 d。治疗结束至少4周后行14C-尿素呼气试验,评估Hp根除率、症状缓解情况和不良反应。结果:与对照组相比,治疗组PP分析和ITT分析Hp根除率均显著升高(PP:94.7%对73.7%,P=0.012;ITT:90.0%对70.0%,P=0.025),症状缓解率显著升高(92.1%对65.8%,P<0.05),而不良反应发生率无明显差异(12.5%对10.0%,P>0.05)。结论:含呋喃唑酮的四联疗法对Hp根除失败者的疗效明显高于三联疗法,且不良反应无明显增加,可作为一线方案用于临床根除Hp。
With the increase of incidence of antibiotic resistance, Helicobacter pylori （Hp） eradication rate of standard triple therapy has gradually decreased in recent years. Aims ： To compare the efficacy and safety of furazolidone- containing triple and quadruple therapy as rescue therapy for Hp-positive chronic gastritis patients. Methods： Eighty Hp- positive patients in whom standard triple therapy （ proton pump inhibitor ＋ amoxicillin ＋ clarithromycin or metronidazole ） failed were enrolled, and were randomly divided into two groups. Patients in the control group received esomeprazole 20 mg bid ＋ amoxieillin 1 g bid ＋ furazolidone 0.1 g bid for 10 days, while patients in the treatment group received esomeprazole 20 mg bid ＋ amoxicillin 1 g bid ＋ furazolidone 0.1 g bid ＋ colloidal bismuth subcitrate 220 mg bid for 10 days. ~4C-urea breath test was conducted at least 4 weeks after completion of the treatment course, Hp eradication rate, symptom relief and side-effects were evaluated. Results： Compared with the control group, PP and ITr analysis of Hp eradication rates were significantly increased in the treatment group （PP： 94.7% vs. 73.7% , P =0. 012; ITY： 90.0% vs 70.0% , P = 0.025）, symptom relief rate was significantly increased （92. 1% vs. 65.8%, P 〈 0.05）, however, no significant difference in incidence of side-effects was found between the two groups （12.5% vs. 10.0% , P 〉 0.05 ）. Conclusions： Furazolidone-eontaining quadruple therapy is more efficient for paitents with failed Hp eradication than triple therapy, and side-effects is not significantly increased, which can be used as a first-line treatment for Hp eradication.
出处
《胃肠病学》
2014年第6期350-353,共4页
Chinese Journal of Gastroenterology
关键词
三联疗法
四联疗法
补救治疗
幽门螺杆菌
呋喃唑酮
Triple Therapy
Quadruple Therapy
Rescue Therapy
Helicobacter pylori
Furazolidone
