10天序贯和标准三联疗法根除幽门螺杆菌的疗效比较

Comparison of sequential therapy and standard triple therapy for Helicobacter pylori eradication

目的评估新的序贯疗法对幽门螺杆菌的根除率。方法我院91例慢性胃炎患者纳入研究。幽门螺杆菌感染由组织学、尿素酶和尿素酶呼气试验评估。序贯疗法包括埃索美拉唑、阿莫西林治疗5天,随后以埃索美拉唑、克拉霉素和替硝唑治疗另外的5天。对照组标准三联疗法包括埃索美拉唑、阿莫西林和克拉霉素治疗10天。幽门螺杆菌的根除率以意向性分析(ITT)和完成治疗分析(PP)表示。根除疗效的判断根据治疗后6周的尿素酶呼气试验结果。结果序贯治疗对慢性胃炎患者的幽门螺杆菌感染获得86.36%(95%CI=81.19%-91.53%)和92.68%(95%CI=88.62%-96.74%)的根除率,但是和10天标准三联治疗相比较差异没有统计学意义。结论序贯治疗能获得较高的幽门螺杆菌根除率,但和10天标准三联治疗比较未获得显著的统计学差异。

Objective To assess the eradication rate of Helicobacter pylori and the acceptability of a new sequential therapy through a pilot study.Methods Ninety-one patients with chronic gastritis were recruited from our hospital.H.pylori status was assessed by histology,urease test or urea breath test.Sequential therapy consisted of a 10-day treatment including Esomeprazole 20 mg bid plus Amoxicillin 1 g bid for the first 5 days,followed by Esomeprazole 20 mg bid,Clarithromycin 500 mg bid and Tinidazole 500 mg bid for the next 5 days.Standard triple therapy included Esomeprazole 20 mg bid,Amoxicillin 1 g bid and Clarithromycin 500 mg bid for 10 days.Eradication rates ware determined 6 weeks after the end of treatment by urea breath test.Eradication rates ware calculated both per-protocol and by intention-to-treat.Results The eradication rate achieved with the sequential in the intention-to-treat analysis and per-protocol cure rate were 86.36%（95%CI=81.19%-91.53%）and 92.68%（95%CI=88.62%-96.74%）,but not achieve the statistic significant comparing with 10 d standard triple therapy.Conclusion Sequential therapy is effective for eradicating H.pylori but do not achieve statistically significant compared with 10 d standard triple therapy.