摘要
目的比较含铋剂的四联疗法与序贯疗法对初次幽门螺杆菌(Hp)根治失败患者补救治疗的临床疗效。方法将180例于2013年3月至2014年11月根除Hp初治不成功者,按随机数字表法分成3组:序贯疗法组、四联疗法的10d疗程组和14d疗程组,治疗结束4周后再复查^(13)C-尿素呼气试验等,以了解Hp根除效果,并比较其不适症状好转情况,不良反应及依从性。结果分别经按意向治疗和按方案分析,四联疗法的14d疗程组的Hp根除率明显高于序贯疗法组(86.7%比65.0%和89.7%比75.0%,均P<0.05),而四联疗法10d疗程组根除率与序贯疗法组相比无统计学差异(71.7%比65.0%和72.9%比75.0%,均P>0.05);四联疗法14d疗程组患者症状改善总有效率也显著高于序贯疗法及四联治疗方法 10d疗程组(89.7%比71.2%和89.7%比76.3%,均P<0.05);3组患者的各种不良反应及依从性比较差异均无统计学意义。结论 Hp根除不成功的患者,包括雷贝拉唑、多西环素、呋喃唑酮及铋剂的四联治疗方案和序贯疗法方案都是一种有效的补救疗法,但与序贯疗法相比,疗程为14d的四联治疗方案对Hp的根除效果更好。
Objective To evaluate the efficacy of standard quadruple therapy containing rabeprazole, doxycycline, furazolidone, bismuth and sequential therapy as rescue therapies for patients who failed to eradicate Helicobacter pylori(Hp). Methods One hundred and eighty patients who failed to eradicate Hp from 2013 March to 2014 November in Quzhou People's Hospital were randomly assigned into sequential therapy group, 10 day-quadruple therapy group and 14-day quadruple therapy group. Four weeks after the end of treatment, ^13C-urea breath test was re-examined. The Hp eradication rate, clinical symptoms improvement, side effects and compliance were compared among three groups. Results Hp eradication rates according to intent-to-treat (ITT) and per-protocol (PP) analyses in 14-day quadruple therapy group were significantly higher than those in sequential therapy group (86.7% vs.65.0% and 89.7% vs. 75.0%, both P 〈0.05), but there was no difference between 10-day quadruple therapy group and sequential therapy group (71.7% vs. 65.0% and 72.9% vs. 75.0%, both P 〉0.05), The clinical symptoms improvement in 14-day quadruple therapy group were more markedly than that in sequential therapy group and 10-day quadruple therapy group (89.7% vs. 71.2% and 89.7% vs. 76.3%, both P 〈0.05); there were no significant differences in incidence of adverse reactions among three groups. Conclusion Both quadruple therapy and sequential therapy can be used as a rescue therapy for eradication of Hp in patients with failed Hp eradication; however, the efficacy of 14-day quadruple therapy is superior to sequential therapy.
出处
《浙江医学》
CAS
2015年第23期1906-1909,共4页
Zhejiang Medical Journal
关键词
幽门螺杆菌
序贯疗法
四联疗法
补救治疗
H. pylori Quadruple therapy Sequential Therapy Rescue Therapy