小剂量奥硝唑联合奥美拉唑根除幽门螺杆菌的疗效观察

Efficacy of low-dose ornidazole combined with omeprazole in the eradication of Helicobacter pylori

目的观察小剂量奥硝唑联合奥美拉唑根除幽门螺杆菌(Hp)的疗效,探索一种简单根除Hp的方法。方法选取深圳市福田区妇幼保健院2016年1月至2017年4月内科就诊的13C尿素呼气试验阳性患者140例,根据随机数表法分为观察组和对照组,每组70例。观察组服用小剂量奥硝唑+奥美拉唑,对照组服丽珠维三联,疗程10 d。观察药物不良反应,停药4周后复查13C尿素呼气试验,比较两组患者的HP根除率,并进行成本效果分析。结果观察组患者的Hp根除率为31.43%,低于对照组的46.38%,治疗总有效率为82.86%,低于对照组的84.38%,但差异均无统计学意义(P>0.05);观察组患者的不良反应发生率为2.86%,明显低于对照组的14.30%,差异具有统计学意义(P<0.05);观察组成本效果比值为0.93,明显低于对照组的4.49。结论小剂量奥硝唑联合奥美拉唑根除Hp有一定的疗效,服药数量少、成本低、不良反应少、耐受性好,可作为三联疗法不能耐受患者的一种备选方案。

Objective To observe the clinical efficacy of low-dose ornidazole combined with omeprazole in eradication of Helicobacter pylori（Hp）, and to explore a simple method for the eradication of Hp. Methods A total of140 patients positive in13 C urea breath test treated in Department of Internal Medicine, Women and Children Health Care Hospital of Futian District of Shenzhen from January 2016 to April 2017 were selected. They were randomly divided into observation group and control group according to the random number table method, with 70 patients in each group. The observation group applied low-dose ornidazole combined with omeprazole, and the control group used Livzon Weisanlian, with a course of 10 days. The adverse drug reactions were observed, and13 C urea breath test was rechecked 4 weeks after withdrawal. HP eradication rate was compared between the two groups, and cost effectiveness analysis was carried out. Results The Hp eradication rate and total effective rate of treatment in observation group were 31.43% and 82.86%, respectively, which were lower than 46.38% and 84.38% in the control group, but the differences were not statistically significant（P〉0.05）. The incidence of adverse reactions in the observation group was 2.86%,which was significantly lower than 14.30% in the control group（P〈0.05）. The cost effectiveness ratio of the observation group was 0.93, which was significantly lower than 4.49 of the control group. Conclusion Low-dose ornidazole combined with omeprazole has certain curative effect on the eradication of Hp, which has the advantages of less dosage, low cost, less adverse reactions and good tolerance. It can be used as an alternative for triple therapy-intolerant patients.