序贯疗法与标准三联疗法治疗幽门螺杆菌阳性慢性糜烂性胃炎患者的疗效比较

Efficacy of treatment in cases of chronic erosive gastritis with Helicobacter pylori infection: a comparison study between sequential treatment regimen and conventional triple therapy.

目的评价序贯疗法与标准三联疗法对幽门螺杆菌(Hp)阳性慢性糜烂性胃炎患者根除Hp的效果及安全性。方法胃镜快速尿素酶实验阳性的77例慢性糜烂性胃炎患者随机分为两组:治疗组39例给予雷贝拉唑20 mg、阿莫西林1 000 mg口服5 d后再给予雷贝拉唑20 mg/d、克拉霉素500 mg和替硝唑500 mg口服5 d,均2次/d;对照组38例给予雷贝拉唑20 mg/d、克拉霉素500 mg和阿莫西林1 000 mg口服10 d,均2次/d;治疗后4周行快速14C-尿素呼气试验。结果 4周后疗程结束时,治疗组总有效率94.8%,对照组总有效率73.6%,两组疗效比较有非常显著性差异(P<0.01);治疗组14C-尿素呼气试验转阴率为92.3%,对照组转阴率为71.1%,两组Hp转阴率比较具有显著性差异(P<0.05)。结论 10 d序贯疗法治疗Hp的根治率较传统三联疗法高,易耐受,安全可靠。

Objective To compare the eradication rate of H.pylori infection and safety between a new sequential therapeutic regimen and conventional triple therapy in treatment of patients with chronic erosive gastritis.Methods Seventy seven patients with chronic erosive gastritis infected with H.pylori detected by rapid urease test were randomly divided into 2 groups.Patients in trial group received 10-day sequential therapy（39 cases） including rabeprazole（20 mg daily） plus amoxicillin（1g twice daily） for the first 5 days,followed by rabeprazole（20 mg daily）,clarithromycin（500 mg） and tinidazole（500 mg） twice daily for other 5 days;and patients in triple therapy group（38 cases） received standard 10-day treatment including rabeprazole（20 mg daily）,clarithromycin（500 mg） and amoxicillin（1 g） twice daily for 10 days.The status of H.pylori was assessed by 14C-urea breath test at base level 4 weeks after treatment.Results There was significant difference in total effective rate between trial group（94.8%） and control group（73.6%）（P 0.01）.The eradication rate of 10 day sequential therapy was 92.3% and that of control group was 71.1%,and there was significant difference between these two groups（P0.05）.Conclusion 10 day sequential therapy is more effective and well-tolerated with higher rate of eradication than 10 day traditional trigeminy therapy.