基于莫西沙星和埃索美拉唑镁的三联疗法对幽门螺旋杆菌根除效果的临床观察

Clinical observation of triple therapy of moxifloxacin and esomeprazole magnesium for Helicobacter Pylori

目的评价基于莫西沙星和埃索美拉唑镁的三联疗法对初治幽门螺旋杆菌(Hp)感染的根除效果。方法将126例患者分为莫西沙星组和对照组,莫西沙星组给予莫西沙星、埃索美拉唑镁、克拉霉素;对照组给予奥美拉唑、阿莫西林、克拉霉素,疗程均为2周。治疗结束1个月后进行内镜检查(活组织病理学检查)和快速尿素酶试验以及13碳/14碳尿素酶呼气试验(13C/14C—UBT),比较药物不良反应及依从性情况。结果莫西沙星组与对照组按意向治疗(ITT)Hp根除率分别为75.0%和58.1%(P<0.05);按符合方案(PP)Hp根除率分别为92.3%和69.2%(P<0.05)。不良反应和药物依从性比较,两组差异均无统计学意义(P>0.05)。结论基于莫西沙星和埃索美拉唑镁的三联疗法对初治Hp感染有较高根除率,药物不良反应和依从性与标准三联疗法无差异,可考虑作为一线治疗方案。

Objective To evaluate the efficacy of triple therapy of moxifloxacin and esomeprazole magnesium to eradicate Helicobacter pylori（ Hp）. Methods A total of 126 patients were randomly divided into moxifloxacin group and control group. The moxifloxacin group was treated with moxifloxacin,esomeprazole and clarithromycin,while the control group was treated with omeprazole,amoxicillin and clarithromycin. Both treatments lasted for 2 weeks. One month after the treatment,the patients undertook endoscopic examination（ pathological biopsy）,rapid urease test and^13 carbon /^14 carbon urea breath test（^13C /^14C—UBT）. The adverse drug reactions and compliance were observed.Results In intention to treat（ ITT） analysis,the Hp-eradication rate was 75. 0% in the moxifloxacin group,and58. 1% in the control group（ P〈0. 05）; in per protocol（ PP） analysis,the Hp-eradication rate was 92. 3% in the moxifloxacin group,and 69. 2% in the control group（ P〈0. 05）. However,in the adverse drug reaction and compliance comparison analysis,there was no statistical difference between the two groups（ P〉0. 05）. Conclusion The triple therapy based on moxifloxacin and esomeprazole is highly effective to eradicate Hp infection,with no significant difference in the adverse drug reaction and compliance from the conventional triple therapy; therefore,it is worthy of clinical spread.