序贯疗法与标准三联、新四联疗法治疗幽门螺杆菌感染疗效比较

Comparison with Clinical Effects of 10 days Sequential Therapy,Standard Triple Therapy and Quadruple Therapy on Patients with Helicobacter Pylori

目的：比较10 d序贯疗法、标准三联疗法以及新四联疗法治疗幽门螺杆菌（Hp）感染的临床效果。方法：153例Hp感染患者随机分为序贯组、标准三联组、新四联组各51例。序贯组予奥美拉唑肠溶片、阿莫西林片（1~5 d）和奥美拉唑肠溶片、克拉霉素缓释片和甲硝唑片（6~10 d）序贯治疗;标准三联组予奥美拉唑肠溶片、阿莫西林片、克拉霉素缓释片三联疗法,疗程7 d;新四联组予奥美拉唑肠溶片、阿莫西林片、克拉霉素缓释片、胶体果胶铋胶囊四联疗法,疗程7 d。3组患者疗程结束后继续服用奥美拉唑肠溶片治疗4周。治疗后比较三组患者Hp根除率、溃疡愈合情况、疼痛及其他症状缓解情况,以及治疗期间药品不良反应发生情况。结果：序贯组患者Hp根除率、溃疡愈合总有效率、疼痛缓解率等指标均明显优于标准三联组和新四联组,疼痛及其他症状缓解时间明显短于标准三联组和新四联组,药品不良反应发生率也明显低于标准三联组和新四联组,差异均有统计学意义（P〈0.05）。新四联组与标准三联组各项指标比较,差异无统计学意义（P〉0.05）。结论：10d序贯疗法治疗Hp感染,可显著提高Hp根除率,促进溃疡愈合,明显缓解疼痛及其他临床症状,且安全性高,值得临床推广。

Objective： To compare with the clinical effects of 10 days sequential therapy,standard triple therapy and quadruple therapy on the patients with helicobacter pylori（ Hp）. Methods： One hundred and fifty three patients with Hp were divided into sequential therapy group,standard triple therapy group and quadruple therapy group at random,each 51 patients. Omeprazole enferic coated tablets and amoxicillin tablets were applied in the sequential therapy group at days 1-5,and omeprazole enferic coated tablets,clarithromycin sustained released tablets and metronidazole tablets were applied at day 6-10; Omeprazole enferic coated tablets,amoxicillin tablets and clarithromycin sustained released tablets were applied to the standard triple therapy group for 7 days; omeprazole enferic coated tablets,amoxicillin tablets,clarithromycin sustained released tablets and colloidal bismuth pectin capsules were applied to the quadruple therapy group for 7 days. After those treatments,all the patients were taken omeprazole enferic coated tablets for 4 weeks. The eradication rate of Hp,ulcer healing and symptoms alleviating conditions of 3 groups were compared; and the adverse drug reactions in 3 groups were obversed. Results： The eradication rate,healing rate,remission rate of pain of sequential therapy group were significantly higher than the standard triple therapy group and quadruple therapy group（ P〈0. 05）. Pain and other symptoms relief time in the sequential therapy group were significantly shorter than the standard triple therapy group and quadruple therapy group（ P〈0. 05）. The incidence of adverse drug reactions in sequential therapy group was significantly lower than the standard triple therapy group and quadruple therapy group（ P〈0. 05）. And there were no significantly differences existed between standard triple therapy group and quadruple therapy group（ P〉0. 05）. Conclusion： 10 days sequential therapy group has a better therapeutic effect on the patients with Hp which could decrease the adverse reaction rate and obtain the ideal effect of clinical treatment.