摘要
目的探讨四联疗法与序贯疗法对首次幽门螺杆菌(Helicobacter pylori,H.pylori)根除失败患者的补救治疗的疗效。方法将79例首次H.pylori根除失败患者随机分成2组,A组39例,用序贯方案(前5 d:泮托拉唑+左氧氟沙星,后5 d:泮托拉唑+克拉霉素+替硝唑),B组40例,用四联方案(泮托拉唑+胶体果胶铋+阿莫西林+克拉霉素),A、B两组疗程均为10 d。停药4周后复查14C-尿素呼气试验判断H.pylori根除情况。结果 79例患者中,共75例完成抗根除H.pylori治疗周期及随访。按意向性分析(ITT分析),两组H.pylori感染根除率分别为66.67%、70.00%;按符合方案集分析(PP分析),两组H.pylori感染根除率分别为70.27%、73.68%,差异均无统计学意义(P>0.05)。两组不良反应发生率分别为15.4%、10.0%,差异无统计学意义(P>0.05)。A组药品成本低于B组药品成本。结论四联疗法(10 d)及含左氧氟沙星的序贯疗法(10 d)均能有效补救首次根除治疗失败的H.pylori感染,而不良反应均不明显,但从药物经济学角度讲,序贯疗法药品成本优于四联疗法药品成本,10 d序贯疗法更适合推广使用。
Objective To investigate the efficacy of quadruple therapy and sequential therapy in treating patients failed to eradicate H. pylori for the first time. Methods Seventy-nine patients failed to eradicate H. pylori for the first time were randomly divided into two groups ： group A （ n = 39） for quadruple therapy （Pantoprazole ＋ Levofloxacin for the first 5 days, and then Pantoprazole ＋ Clarithromycin ＋ Tinidazole for the last 5 days） and group B （n = 40） for se- quential therapy （Pantoprazole ＋ Colloidal bismuth pectin ＋ Amoxicillin ＋ Clarithromycin for 10 days）. Four-week after the therapies stopped, 14C-urea breath test （UBT） was performed to determine the eradication of H. pylori. Results A total of 79 patients were recruited, and 75 of them finished all treatment and follow-up. The eradication rates of H. pylori infection in group A and group B were 66.67% and 70.00% , respectively with Intention-to-treat analysis; the eradica- tion rates in group A and group B were 70.27% and 73.68% , respectively with per-protocol analysis. No statistical sig- nificance was found between two groups （P 〉 0.05）. The incidences of adverse drug reactions in group A and group B were 15.4% and 10.0% , respectively, and there was no statistically significance （P 〉0.05）. The drug cost of group A was lower than that of group B. Conclusion Both quadruple therapy （10 days） and sequential therapy （ 10 days） can effectively eradicate H. pylori infection for patients failed to eradicate H. pylori for the first time. And no obvious ad- verse effects are found. However, from the perspective of pharmacoeconomies, the cost of sequential therapy is lower than that of quadruple therapy, and 10 days sequential therapy is more suitable for the application.
出处
《胃肠病学和肝病学杂志》
CAS
2016年第1期70-73,共4页
Chinese Journal of Gastroenterology and Hepatology
关键词
幽门螺杆菌
四联疗法
序贯疗法
疗效
Helicobacter pylori
Quadruple therapy
Sequential therapy
Curative effect
