常规三联与四联疗法治疗幽门螺杆菌阳性消化道溃疡的疗效比较

Comparison of the Efficacy of Conventional Triple/Quadruple Therapy for Patients with Hp Positive in the Digestive Tract Ulcer

目的:比较常规三联与四联疗法治疗幽门螺杆菌(Hp)阳性消化道溃疡的疗效和安全性。方法:96例Hp阳性消化道溃疡患者随机分为对照组(48例)和观察组(48例)。观察组患者给予雷贝拉唑肠溶片10 mg/次,2次/d+阿莫西林胶囊1.0 g/次,2次/d+克拉霉素胶囊0.5 g/次,2次/d+枸橼酸铋钾颗粒220 mg/d,2次/d。对照组患者给予雷贝拉唑肠溶片10 mg/次,2次/d+阿莫西林胶囊1.0 g/次,2次/d+克拉霉素胶囊0.5 g/次,2次/d。两组疗程均为14 d。比较两组患者Hp根除情况,临床症状改善情况,溃疡愈合情况和不良反应发生情况。结果:观察组患者Hp根除率、临床症状改善率、溃疡愈合率显著高于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:常规四联疗法在提高Hp根除率,改善患者临床症状和溃疡愈合情况方面优于常规三联疗法,两者安全性相当。

OBJECTIVE： To compare the efficacy and safety of conventional triple/quadruple therapy for patients with Hp posi- tive in the digestive tract ulcer. METHODS： 96 patients with Hp infection in the digestive tract ulcer were randomly divided into control group （48 cases） and observation group （48 cases）. Observation group received Rabeprazole enteric-coated tablet 10 mg/ times, twice/d ＋ Amoxicillin capsule 1.0 g/times, twice/d＋Clarithromycin capsule 0.5 g/times, twice/d ＋Bismuth potassium citrate capsule 220 mg/d, twice/d. Control group received Rabeprazole enteric-coated tablet 10 mg/times, twice/d ＋ Amoxicillin capsule 1.0 g/times, twice/d ＋ Clarithromycin capsule 0.5 g/times, twice/d. They treated for 14 d. Hp eradication, improvement of clinical symptoms, ulcer healing and the incidence of adverse reactions in 2 groups were compared. RESULTS ： The Hp eradication rate, to- tal effective rate of the improvement of clinical symptoms and total effective rate of ulcer healing in observation group were signifi- cantly higher than control group, with statistical significance （P〈0.05）. And there was no significant difference in the total inci- dence of adverse reactions in 2 groups （P〉0.05）. CONCLUSIONS： The efficacy of conventional quadruple therapy is superior to conventional triple therapy in the treatment of Hp infection in the digestive tract ulcer, which can improve Hp eradication rate, clin- ical symptoms and ulcer healing, with similar safety.