含铋剂及雷贝拉唑的四联疗法在Hp根除失败后补救治疗应用的效果评价

Effect of containing bismuth agent and rabeprazole azole quadruple therapy on Hp teradication failure of remedial treatment

目的探讨含铋剂及雷贝拉唑的四联疗法在Hp根除失败后补救治疗中的应用效果。方法 80例经传统三联疗法治疗失败的患者随机分对照组(40例)和观察组(40例),对照组予以序贯疗法,继续口服泮托拉唑40 mg、阿莫西林1 000 mg、克拉霉素500 mg,2次/d,疗程10 d,后泮托拉唑40 mg,1次/d,延续21 d;观察组予以雷贝拉唑20 mg+枸橼酸铋钾胶囊220 mg+阿莫西林1 000 mg+克拉霉素500 mg,2次/d,疗程10 d,后雷贝拉唑20 mg,1次/d,延续21 d。结果两组间消化性溃疡或慢性胃炎的Hp根除率比较差异无统计学意义(P>0.05)。PP与ITT分析均显示,观察组溃疡愈合率与对照组比较差异有统计学意义(P<0.05);两组症状缓解情况比较差异无统计学意义(P=0.133);两组不良反应发生率比较差异无统计学意义(P=0.476)。结论对于初次根治Hp失败的患者,两种治疗方案均能有效改善患者的症状,能显著促进溃疡愈合并提高Hp的根治率,但采用含铋剂及雷贝拉唑的四联法疗效更令人满意。

Objective To observe the effect of containing bismuth agent and rabeprazole azole quadruple therapy on Hp teradication failure of remedial treatment. Methods 80 cases of patients with traditional treatment failure,were divided into the control group（40 cases） and observation group（40 cases）,the control group using sequential therapy,oral diazepamtora azole 40 mg,amoxicillin 1 000 mg and clarithromycin 500 mg,twice a day,10 d a course,then panxi tora azole 40 mg,once a day,lasting for 21 days;Observation group with rabeprazole azole 20 mg ＋ 220 mg of bismuth potassium citrate capsules 1 000 mg ＋ amoxicillin clarithromycin 500 mg,twice a day,10 d a course,then rabeprazole azole 20 mg,once a day,lasting for 21 days. Results There was no significant difference in the Hp eradicate rate of peptic ulcer,chronic gastritis between observation group and control group（P ＆lt; 0. 05）. PP and ITT analysis showed that the ulcer healing rate of observation group had significant difference than control group（P ＆lt; 0. 05）. The effectiveness and adverse reactions of the two groups had no significant difference（P ＆gt; 0. 05）. Conclusion Both treatment can improve the patient’s symptoms,promote ulcer healing,and improve the curative rate of the Hp,but with containing bismuth agent and rabeprazole azole quad method has more satisfactory curative effect.