幽门螺杆菌根除治疗中联合用药研究进展

Research Progress of Combination Treatment in Helicobacter Pylori Eradication

幽门螺杆菌(HP)是慢性胃炎及消化性溃疡的重要病因之一,与胃癌密切相关,世界卫生组织国际癌症研究机构(IARC)已将其列为Ⅰ级致癌因子。然而,幽门螺杆菌可导致胃黏膜组织炎症,其持续性炎症诱发恶性转化的机制也有待进一步研究。该文介绍了幽门螺杆菌的传播、致病机理等基本信息,并着重介绍了根除治疗的联合用药疗法。常用的根治方案药物分为单一用药和联合用药,主要是三联疗法和四联疗法。二联疗法是同时使用质子泵抑制剂加羟氨苄青霉素;三联疗法是以铋剂为主,再用2种抗生素或以1种质子泵抑制剂为主加用2种抗生素;四联疗法为质子泵抑制剂加铋剂加2种抗生素。该文汇总了近些年常用的治疗方法,并分析其利弊。

Helicobacter pylori （HP） is closely related to gastric cancer, and is an important factor of infecting chronic gastritis and pep- tic ulcer. Helicobacter pylori has been listed as a Class I carcinogen by World Health Organization IARC. However, the gastric inflam- mation caused by Helicobacter pylori, as well as the malignant transformation mechanism of persistent inflammation of HP need study further. This paper briefly introduces the spread, pathogenesis and other basic information of Helicobacter pylori, describes the combination therapy of eradicating HP in detail. People all over the world have commonly infected with HP, especially in our country, most of the people have been infected with HP. Therefore, there is a urgent need to explore an ideal treatment for HP infection, which is of great significance. The common drugs for HP infection are divided into single drug and combined drugs, which are triple therapy and quadru- ple therapy based. Bigeminy therapy is a combine of proton pump inhibitors （PPIs） and amoxicillin. Triple therapy is either bismuth based, with 2 antibiotics, or PPIs with bismuth and 2 antibiotics. Quadruple therapy consists of PPIs, bismuth and 2 antibiotics. This arti- cle summarizes these commonly used treatments in recent years, and analyzes the advantages and disadvantages of them.