含左氧氟沙星序贯疗法对幽门螺杆菌感染补救治疗的疗效分析

Levofloxacin- containing Sequential Therapy for Helicobacter Pylori Infection:Efficacy of Remedial Therapy

目的比较由埃索美拉唑、左氧氟沙星、阿莫西林、呋喃唑酮、丽珠得乐组成的10日序贯疗法与标准的10日四联疗法对幽门螺杆菌(H.pylori,Hp)感染补救治疗的疗效及安全性。方法将72例初次根除治疗失败的幽门螺杆菌阳性患者,随机分为两组。治疗组前5日应用埃索美拉唑20mg加左氧氟沙星200mg及阿莫西林1000mg,每日2次口服,后5日用埃索美拉唑20mg加左氧氟沙星200mg、呋喃唑酮100mg及丽珠得乐220mg,每日2次口服;对照组采用10d埃索美拉唑20mg,呋喃唑酮100mg,四环素750mg,丽珠得乐220mg,每日2次口服。观察服药期间患者不良反应的发生例数和症状缓解情况,停药4周后复查幽门螺杆菌。结果治疗组幽门螺杆菌根除率91.9%,对照组82.8%,差异有统计学意义(P<0.05);不良反应发生率分别为10.8%和22.9%,差异有统计学意义(P<0.05)。结论由埃索美拉唑、左氧氟沙星、阿莫西林、呋喃唑酮、丽珠得乐组成的10日序贯疗法治疗成人幽门螺杆菌感染具有疗效高、安全性好等优点。

Objective To evaluate whether lO-day sequential therapy including esomeprazole,levofloxacinand,amoxicillin,amoxicillin, furazolidone and Lizhu Dele remedial therapy in Helicobacter pylori infection is better than 10-day standard quadruple therapy and the risk of adverse events between these two regimens. Methods Seventy-two Helicobaeter pylori-positive patients with treatment failure of initial eradication were randomly divided into two groups：treatment group and control group, and the treatment group （37 patients）was treated with esomeprazole 20mg,levofloxacinand 200mg,amoxicillin 1000mg at first five days,orally two times a day at first five days and esomeprazole 20mg,levofloxacin 200mg,furazolidone 100mg and Lizhu Dele 220mg,orally two times a day at the second five days. The control group （35 patients）was treated with esomeprazole 20mg,levofloxacinand 200mg,furazolidone 100mg and tetracycline 750rag,orally two times a day for ten days. The incidence of adverse events during the medication was observed and Helicobacter pylori was detected 4 weeks after discontinuation. Results The eradication rate of the lO-day sequential therapy was 91.9% and that of the control group was 82.8% ,with a significant difference between the two groups （P〈0.05）. The incidence rat of adverse events of the 10-day sequential therapy was 10.8% and that of the control group was 22.9% ,with a significant difference between the two groups （P〈0.05）. Conclusion The sequential therapy in the composition of esomeprazole,levofloxacinand,amoxicillin,amoxicillin,furazohdone and Lizhu Dele is safe and more effective compared with standard quadruple therapy for re-eradicating Helicobacter pylori infection.