10日序贯疗法治疗幽门螺杆菌感染

Eradication of Helicobacter pylori with 10 day sequential therapy

目的评价序贯疗法与标准三联疗法对幽门螺杆菌(Hp)根除的疗效。方法经胃镜及组织学检查确诊为有明显异常的慢性胃炎(指合并糜烂、中至重度萎缩、中至重度肠化生或轻至中度不典型增生)或消化性溃疡且Hp阳性。将患者68例随机分为2组,治疗组(36例,序贯疗法):前5 d,埃索美拉唑40 mg,qd+阿莫西林1 000 mg,bid;后5 d,埃索美拉唑40 mg,qd+克拉霉素500 mg,bid+替硝唑500 mg,bid;对照组(32例,标准三联疗法):埃索美拉唑40 mg,qd+阿莫西林1000 mg,bid+克拉霉素500 mg bid,疗程7 d。所有患者停药4周以上行13C呼气试验检测Hp根除率。结果治疗组Hp根除率91.7%,对照组根除率71.9%,两组比较差异有统计学意义(P<0.05)。结论序贯疗法治疗Hp感染优于标准三联疗法,是一种安全、有效的治疗方案。

Objective To evaluate the effect of 10-day sequential therapy for eradication of Helicobacter pylori.Methods 68 patients with Hp positive chronic gastritis（complicated with erosion,moderate to severe atrophy,intestinal metaplasia,mild to moderate dysplasia） or peptic ulcer were randomly divided into two groups,group 1（36 cases,sequential therapy） were treated with esomeprazole,40mg,qd＋ amoxillin 1000mg,bid at first five days,with esomeprazole,40mg,qd＋ clarithromycin 500mg,bid ＋ tinidazole 500mg,bid at second five days,group 2（32 cases,triple therapy） were treated with esomeprazole,40mg,qd＋ amoxillin 1000mg,bid ＋ clarithromycin 500mg,bid for seven days.13C-urea breath test were employed to examine whether Hp is eradicated four weeks after treatment.Results The eradication rate of 10-day sequential therapy was 91.7%,triple therapy was 71.9%,the difference between two groups was signifcant.Conclusion 10-day sequential therapy could achieve higher eradication rate of Hp compared to 7-day triple regimen.