4种三联疗法根治幽门螺杆菌的临床疗效观察

Efficacy of 4 kinds of triple strategy for Helicobacter pylori eradication

目的:观察4种三联疗法根治幽门螺杆菌(Hp)的疗效及安全性。方法:选择快速尿素酶及14C-尿素呼气试验确诊的307例Hp感染患者,随机分为4组:A组80例,B组76例,C组77例,D组74例。其中A组采用雷贝拉唑、克拉霉素、呋喃唑酮三联方案;B组用枸橼酸铋雷尼替丁(RBC)、克拉霉素、呋喃唑酮三联方案;C组采用雷贝拉唑、阿莫西林、呋喃唑酮三联方案;D组采用枸橼酸铋雷尼替丁、阿莫西林、呋喃唑酮三联方案。疗程结束4周后复查快速尿素酶及14C-尿素呼气试验。结果:A组Hp根除率90.0%,B组Hp根除率67.1%,C组Hp根除率62.3%,D组Hp根除率45.9%。A组与B组、C组Hp根除率比较,差异有统计学意义(P<0.05),B,C组高于D组,差异有统计学意义(P<0.05),B组和C组比较,差异无统计学意义(P>0.05)。4组中不良反应无明显差异。结论:雷贝拉唑、克拉霉素、呋喃唑酮三联疗法在4种方案中Hp根治率最高,值得临床推广。

Objective To evaluate the efficacy and safety of 4 kinds of triple strategy of Heli- cobacter pylori（ Hp ） eradication. Methods A total of 307 patients who suffered from Hp infection, confirmed by rapid urease test（RUT） and ^14C-urea breath test（ UBT）, were randomly divided into 4 groups. Each group had 80, 76, 77, and 74 patients respectively. Group A was treated with rabeprazole, clarithromycin, and furazolidone （RCF） ;Group B with ranitidine bismuth citrate, clarithromycin, and furazolidone （ BCF ） ; Group C with rabeprazole, amoxicillin, and furazolidone （ RAF ） ; while Group D with ranitidine bismuth citrate, amoxicillin, and furazolidone （BAF）. Hp was detected by RUT and UBT at 4 weeks after later treatment. Results lip eradication rates of group A, B,C, and D were 90. 0% ,67. 1% , 62. 3%, and 45. 9% , respectively. The difference between Group A and Group B, Group A and Group C was significant （ P 〈0.05 ）. Eradication rate of Group B and C was higher than that of Group D （ P 〈 0.05 ）. There was no statistical difference between the eradication rate of Group B and C, and among the side effects of the 4 groups. Conclusion The strategy of RCF was the best among the 4 triple strategy of Hp eradication, which can be usedclinically.