序贯疗法根除幽门螺杆菌

Sequential Therapy Eradicate Helicobacter Pylori

幽门螺旋杆菌(HP)感染是胃炎、消化性溃疡、胃癌和胃黏膜相关淋巴组织淋巴瘤的主要病因,根除HP具有重大的临床意义。随着抗生素耐药株HP逐年增加,HP根除率日益下降,因此出现了一种新的HP根除方案——10天或14天序贯疗法。此疗法指前5天或7天的诱导期中应用质子泵抑制剂(PPI)加一种抗生素的二联治疗,随后5天或7天应用PPI和两种抗生素的三联治疗。目前除少数研究外,绝大多数临床研究表明序贯疗法能够获得比传统的7天或10天三联疗法更高的HP根除率,其具体机制尚不明确。目前大部分相关的研究为单中心、样本量少,缺乏双盲对照,未能评估抗生素耐药性,尚待大样本、多中心、随机双盲对照的临床研究来进一步证实该疗法的有效性和安全性。

The infection of Helicobacter Pytori （Hp） is a main cause of gastritis, peptic ulcer, gastric carcinoma and gastric lymphoma mucosa associated lymphoid tissue. The eradication of HP is of important significance. Now HP strain that is resistant to antibiotics becomes more and more, and the eradication rate of HP decreases. Therefore, a new eradication ther apy, that is, sequential therapy made up of 10 or 14 days was invented. Sequential therapy means in the first 5 or 7 days the patients take proton pump inhibitor （PPI） and a kind of antibiotic, and in the second 5 or 7 days the patients take PPI together with two kinds of antibiotics. Except for a few researches, most researches showed the eradication rate of sequential therapy was higher than that of traditional triple therapy, but the mechanism was unclear. Now most related researches were single center, small sample, short of double--blind control. Multicenter, large sample, random double--blind control researches were needed to check the efficacy and safety of sequential therapy.