序贯疗法根除幽门螺杆菌的疗效观察

Sequential therapy with esomeprazole in the efficacy of anti-Helicobacter pylori

目的：观察序贯疗法根除幽门螺杆菌的疗效,探讨提高幽门螺杆菌根除率的有效方法。方法：我院2010年2月~12月间经胃镜病理及快速尿素酶试验诊断幽门螺杆菌阳性589例,其中第一次根除Hp治疗失败患者102例。将其随机分为治疗组和对照组。治疗组（50例）采用埃索美拉唑＋阿莫西林＋克拉霉素＋替硝唑的序贯疗法治疗,对照组（52例）采用埃索美拉唑＋可乐必妥＋克拉霉素＋替硝唑的标准四联疗法治疗。结果：治疗后停药4周复查,治疗组的临床有效率（92%）显著高于对照组（73%）（P〈0.05）。治疗组复查Hp,48例阴性,2例阳性,根除率96%。对照组复查Hp,36例阴性,16例阳性,根除率为69.2%。2组间根除率存在显著性差异（P〈0.05）。结论：最新的序贯疗法是一个高效的根除方案。

Objective：To explore the effect of sequential therapy on improving Helicobacter pylori（Hp）eradica- tion rate and reducing the recurrence.Methods：From February 2010 to December 2010,Hp positive patients were 589 in the hospital through the menstrual gastro-endoseopic pathological and rapid urease test diagnosis. In this paper,after the first time for anti-Hp treatment,102 cases were still positive.They were randomly divid- ed into sequential therapy treatment group （50 cases）and control group （52 cases）The treatment group were treated with esomeprazole＋amoxicillin＋clarithromycin＋tinidazole sequential therapy,in the control group with es- omeprazole ＋levofloxaein＋elarithromyein ＋tindazole therapy.Results ：After treatment,clinical total effective rate of treatment group （92%）was significantly higher than that of control group （73% ,P〈0.05）.After treatment,the treatment group review Hp,48 were negative,2 were positive ,eradication rate was 96%.The control group re- view Hp,36 were negative,16 eases were positive,eradication was 69.2%.Eradication rate between the two groups had significant differences （P〈O.OS）.Conclusion：The latest treatments sequential therapy is a highly ef- fective eradication program and has broad prospects for treatment.