不同疗程四联疗法根除幽门螺杆菌的疗效观察

Study of 4-,5- and 7-day pantoprazole quadruple therapy regimens in the treatment of Helicobacter pylori infection

目的研究泮托拉唑短程四联4、5、7d疗法根除幽门螺杆菌（Hp）的疗效。方法166例经胃镜证实Hp阳性的重度胃炎患者随机分为泮托拉唑四联疗法4d组、5d组和7d组，均给予泮托拉唑40mg＋枸橼酸铋钾220mg＋克拉霉素250mg＋阿莫西林1g，每日2次治疗，泮托拉唑疗程1周，枸橼酸铋钾疗程2周，克拉霉素、阿莫西林疗程在3组分别为4、5和7d。疗程结束4周后复查Hp，观察Hp根除率、症状缓解率及不良反应等。结果泮托拉唑四联疗法4、5和7d组Hp根除率分别为73．8％（45／61）、75．9％（41／54）和80．4％（41／51）；疼痛缓解率分别为82．4％（42／51）、85．1％（40／47）和88，9％（40／45），各组之间比较差异均无统计学意义（均P〉0．05）。结论泮托拉唑四联短程疗法（4或5d）为安全、有效、符合药物经济学要求的根除Hp的方案。

Objective To compare the efficacy of pantoprazole based short-term quadruple regimens in the treatment of Helicobacter pylori （ H. pylori） infection for 4 days,5 days or 7days. Methods 166 patients with H. pylori associated severe gastritis were randomly divided into pantoprozole quadruple regimens of 4-day group （ n = 61 ） ,5-day group （ n =54） or 7-day group （ n = 51 ）. The regimen was pantoprazole 40 mg,bismuth potassium citrate 220 mg,clarithromycin 250 mg and amoxicillin 1 g twice daily. The patients received pantoprazole for 1 week, bismuth potassium citrate for 2 weeks,clarithromycin and amoxicillin for 4 days,5 days or 7 days respectively. The H. pylori eradication and symptomatic relief was determinded by ^13 C-UBT at least 4 weeks after the therapy. Results The H. pylori eradication rates of 4-day,5-day or 7-day pantoprazole quadruple regimens were 73.8% （45/61） ,75. 9% （41/54） and 80.4% （41/51） respectively. The pain relief rates were 82, 4% （42/51） ,85.1% （40/47） and 88.9% （ 40/45 ） in 4-day,5-day and 7 day group. Conclusion The 4-day and 5- day pantoprazole based quadrual therapy is a shortterm, effective, safe and lower therapeuticcost regimen for H. pylori eradication.