含铋剂的雷贝拉唑四联14日方案根除幽门螺杆菌临床对比观察

Clinical evaluation on 14-day bismuth-rabeprazole-based quadruple therapy for Helicobacter pylori eradication

目的:观察含铋剂的雷贝拉唑四联14 d方案根除幽门螺杆菌(Hp)临床疗效。方法:选择门诊及部分住院Hp检测阳性病人,随机分为克拉霉素组、环丙沙星组、替硝唑组3组,每组均有雷贝拉唑、阿莫西林及胶体果胶铋,而第二种抗生素是不同的,分别是克拉霉素、环丙沙星、替硝唑,疗程14 d。疗程结束4周后,行^(13)C呼气试验判定Hp是否被根除。结果:期末完成方案并行^(13)C呼气试验Hp感染者共80例,含铋剂的雷贝拉唑四联14 d疗法的总根除率为91%,其中克拉霉素组根除率为96%,环丙沙星组根除率为93%,替硝唑组根除率为85%,但3组间Hp根除率差异无统计学意义(P>0.05)。结论:含铋剂的雷贝拉唑四联14 d方案Hp根除率高,克服了Hp的高耐药,值得推荐。各抗生素组合方案间Hp根除率未见差异。

Objective： To assess the clinical efficacy of 14-day bismuth-rabeprazole-based quadruple regimen for eradication of Helicobacter pylori（ H. pylori）. Methods： Outpatients and part of inpatients with positive H. pylori were included and randomly allocated to regimen groups of clarithromycin,ciprofloxacin and tinidazole with prescriptions of rabeprozole,amoxicillin and bismuth. The second regimen contained different antibiotics（ clarithromycin,ciprofloxacin,tinidazole）. All patients underwent therapy courses of 14 day,and assessed for eradication of the H. pylori with^（13）C-urea breath test by the end of 4 weeks of medication. Results： A total of 80 patients infected with H. pylori completed the trial. Overall eradication rate of 14-day bismuth-rabeprazole-based quadruple regimen was 91%,in which the regimen containing clarithromycin was 96%; ciprofloxacin 93%; and tinidazole 85%,yet the difference was not significant among the three groups（ P〈0. 05）. Conclution： 14-day bismuth-rabeprazole-based quadruple regimen can lead to better eradication of the H. pylori,and counteract the antibiotic resistance. However,there is no significant difference concerning regimens containing different antibiotics.