四联疗法治疗耐药幽门螺杆菌感染的疗效分析

Efficacy of amoxicillin and clavulanate in combination with moxifloxacin and esomeprazole in treatment of drug resistant Helicobacter pylor infection

目的观察阿莫西林克拉维酸钾和莫西沙星与埃索美拉唑联用,治疗传统的三联疗法治疗失败的耐药幽门螺杆菌感染的根除率,并与对照组四联疗法比较是否存在差异。方法将85例传统的三联疗法治疗2周以上,经C14呼气试验检查证实治疗失败的耐药幽门螺杆菌感染病例,随机分为试验组及对照组,试验组治疗方案为阿莫西林克拉维酸钾片914mgBid+莫西沙星片400mgQd+埃索美拉唑片20mgBid,对照组治疗方案为埃索美拉唑片20mgBid+胶体酒石酸铋胶囊165mg Qid+阿莫西林胶囊1000mg Bid+克拉霉素500mg Bid,疗程均为1周。结果试验组43例幽门螺杆菌根除率为83.3%,对照组幽门螺杆菌根除率为70%,两组根除率差异有统计学意义(P<0.05)。结论阿莫西林克拉维酸钾和莫西沙星与埃索美拉唑联用治疗传统的三联疗法治疗失败的耐药幽门螺杆菌感染根除率,优于含铋剂的四联疗法,副作用少,可以作为二线治疗方案在临床应用。

Objective To observe the efficacy of amoxicillin and clavulanate potassium combined with moxifloxacin and esomeprazole in treatment of Helicobactor pylori infection failed after treatment with conventional triple therapy for the treatment of failure of drug resistance of Helicobacter pylori infection,and a control group with quadruple therapy for Helicobacter pylori eradication rate difference.Methods The 85 patients with Helicobacter pylori infections and treated with conventional triple therapy for a course of over 2 weeks and confirmed treatment failure by the C14 breath test were randomly divided into therapeutic group and control group.The patients in the therapeutic group were treated with amoxicillin potassium clavulanate 914mg Bid＋ moxifloxacin tablet 400mg Qd＋ esomeprazole 20mg Bid.Those in the control group were treated with esomeprazole 20mg Bid＋ colloidal bismuth tartrate 165mg Qid＋ amoxicillin capsule 1000mg Bid ＋ clarithromycin 500mg Bid,for a course of 1 week.Results About 83.3% of Helicobacter pylori in the patients of therapeutic group was eradicated and eradication rate in the control group was 70% showing significant difference（P0.05）.Conclusions Combined use of amoxicillin and clavulanate potassium,moxifloxacin and esomeprazole is superior to the quadruple therapy containing bismuth in treatment of Helicobactor pylori-infected patients failed with conventional triple therapy.The regimen could be used as the second-line therapy with mild side effects.