10日序贯疗法根除幽门螺杆菌的疗效观察

10-day sequential therapy of helicobacter pylori

目的观察由雷贝拉唑、阿莫西林、克拉霉素、左氧氟沙星组成的10日序贯疗法根除幽门螺杆菌的疗效。方法将92例经电子胃镜明确的消化性溃疡和慢性胃炎伴胃黏膜萎缩或糜烂且Hp阳性成人患者随机分成两组:治疗组(46例)方案为前5 d给予雷贝拉唑10 mg和阿莫西林1000 mg,每日2次口服;后5 d给予雷贝拉唑10 mg、克拉霉素500 mg,左氧氟沙星200 mg,每日2次口服。对照组(46例)方案为标准三联疗法(雷贝拉唑10 mg,阿莫西林1000 mg,克拉霉素500 mg),每日2次,口服10 d。结果治疗组Hp根除率为93.48%(43/46),对照组为73.91%(34/46),两组比较差异有统计学意义(P<0.05)。结论由雷贝拉唑+阿莫西林+克拉霉素+左氧氟沙星组成的10日序贯疗法对成人Hp感染的根除率优于标准三联疗法,且耐受性及依从性均较好。

Objective To observe the efficacy of the 10-day treatment with the combination of rabeprazole,amoxicillin,clarithromycin and levofloxacin to eradicate helicobacter Pylori（Hp）.Methods Ninety-two adult patients,who have peptic ulcer and chronic gastritis accompanied by gastric mucosal atrophy or erosion defined by electronic gastroscope,and Hp-positive were randomly divided into two groups： 46 patients for treatment group,in which they will be given 10 mg rabeprazole and 1000 mg amoxicillin for the first 5 days.Patients need to take the pills 2 times/ day orally.The rest 5 days patients will be prescribed 10 mg rabeprazole,500 mg clarithromycin and 200 mg levofloxacin for 2 times/day.46 patients were assigned in comparison group to be treated in standard triple therapy： 10 mg rabeprazole,1000 mg amoxicillin,and 500 mg clarithromycin for 2 times/day and for 10 days.Results The percentage of eradication of the disease in the treatment group was 93.48%（43 out of 46 patients recovered）,while that in the comparison group was 73.91%（34 out of 46）.It has statistically significant difference between the two groups（P0.05）.Conclusion The 10-day treatment with the combination of rabeprazole,amoxicillin,clarithromycin and levofloxacin is far better than the standard triple therapy in eradicating HP.It also has better tolerance and compliance.