序贯疗法与10天标准疗法抗幽门螺杆菌疗效观察

Efficacy of Sequential Therapy with 10 Days of Standard Therapy against H. Pylori

目的:观察10 d序贯疗法与10 d标准疗法抗幽门螺杆菌疗效,以寻找新的抗幽门螺杆菌方案。方法:2010年5月-2012年4月在本院消化内科住院或门诊治疗、随访的127例患者,经胃镜检查确诊为活动性消化性溃疡并且Hp检查为阳性的患者进行研究。对入选患者分为序贯治疗组与标准治疗组两组,均要求奥美拉唑饭前服,抗生素饭后服,共10 d。停药4周后再行胃镜检查或13C尿素呼气试验以观疗效,对两组的根除率均按意向性治疗分析(ITT),统计学分析采用SPSS 20.0医学统计软件进行字2检验比较。结果:Hp根除率比较:序贯治疗组Hp根除率为95.16%,10 d标准治疗组根除率为81.53%,序贯治疗组的根除率高于标准治疗组,差异有统计学意义(P<0.05);在研究期间两组均无上消化道大出血等严重不良反应发生。两组副反应发生率分别为10/62(16.13%)、10/65(15.38%),差异无统计学意义(P>0.05)。结论:研究表明,抗幽门螺杆菌治疗10 d序贯疗法优于标准三联疗法,具有较高的Hp根除率。

Objective：To observe the 10 day sequential therapy with 10 days of standard therapy against H.pylori efficacy,to find new antiHelicobacter pylori.Method：127 patients with active peptic ulcer diagnosed by endoscopy and Hp checks positive patients were studied from May 2010 to April 2012 in our hospital Gastroenterology hospitalization or outpatient treatment.Enrolled patients were divided into two groups：the sequential treatment group and standard therapy group,omeprazole meals were served,the antibiotic after meals,for a total of 10 days.Discontinued 4 weeks and then underwent endoscopy or13C urea breath test in order to observe the efficacy,the eradication rates of the two groups by intention to treat analysis（ITT）,statistical analyzes were performed using SPSS 20.0 statistical software of Medicine conducted a test to compare.Result：Hp eradication rate comparison： the incidence of side effects of Hp eradication rate of sequential therapy group（95.16%）,the eradication rate of the 10d standard treatment group（81.53%）,the eradication rate of sequential therapy group was higher than the 10d standard treatment group,the difference was statistically significant（P〈0.05）;comparison：during the study period,the sequential treatment group and 10 d standard treatment group had no upper gastrointestinal bleeding and other serious adverse reactions.Two groups incidence of side effects were 10/62（16.13%）,10/65（15.38%）,two sets of side effects were obvious difference was not statistically significant（P〈0.05）.Conclusion：This study showed that the anti-Helicobacter pylori therapy 10 d sequential therapy superior to standard triple therapy,has a higher rate of Hp eradication,whether from a course of treatment,the side effects or the economic load will display its advantages.