序贯疗法与标准四联疗法根除HP的疗效比较

Efficacy Comparison of Sequential Therapy and Standard Quadruple Therapy for Eradication of HP

目的幽门螺杆菌(Helicobacter pylori,Hp)耐药率逐渐增加,标准四联疗法根除率下降,需要新的治疗方法。方法 78例患者随机分成治疗组和对照组,治疗组(序贯疗法)方案为前5d雷贝拉唑+阿莫西林,后5d雷贝拉唑+左氧氟沙星+替硝唑,疗程共10d。对照组(标准四联疗法)方案为雷贝拉唑+阿莫西林+克拉霉素+果胶铋,疗程共10d。所有患者停药4周后复查14C尿素呼气试验检测HP根除率。结果序贯治疗(治疗组)Hp根除率84.6%(33/39),四联疗法(对照组)Hp根除率为71.8%(28/39),两组间比较差异有统计学意义(P<0.05)。结论 10d序贯疗法Hp根除率优于标准四联疗法。

Objective Antibiotics resistance of Helicobacter pylori （HP） increased, eradication rate of conventional quadruple therapy decreased gradually.New fist-line treatments for Hp eradication need to be developed.Methods We have prospectively evaluated 10-day sequential therapy versus conventional quadruple therapy in HP eradication rate.Seventy-eight patients with HP infection were prospectively randomized to receive 5 days of rabeprazole and amoxicillin followed 5 dqys of rabeprazole, Levofloxacin and Tinidazole（sequential-therapy） or 10-days rabeprazole, amoxicillin, clarithromycin and bismuth（conventional quadruple therapy）.HP was detected by the 14C-urea breath test at the fourth week post-treatment.Results HP eradication rates were 84.6% in the sequential therapy group and 71.8% in the conventional quadruple therapy group.The difference between the sequential therapy group and the conventional quadruple therapy group was significant （P〈0.05） .Conclusions 10-day sequential therapy yielded a higher HP eradication rate than 10-day conventional quadruple therapy.