序贯药物方案与四联疗法对Hp阳性慢性胃炎活动期患者Hp根除率及复发的影响

Influence of sequential drug regimen and quadruple therapy on HP eradication rate and recurrence in patients with HP positive chronic gastritis in active stage

目的研究序贯药物方案与四联疗法对幽门螺旋杆菌(Hp)阳性慢性胃炎活动期患者Hp根除率及复发的影响。方法选择2018年8月—2019年11月本院收治的91例Hp阳性慢性胃炎活动期患者作为研究对象,采用双盲法分为A组(n=45)和B组(n=46)两组。A组给予四联疗法治疗,B组给予序贯药物方案治疗。对比两组患者的治疗14 d后的Hp根除率、症候积分、3个月和6个月复发率以及治疗期间不良反应。结果 A组Hp根除39例(84.78%),B组Hp根除42例(93.33%),B组根除率较A组高,差异无统计学意义(χ^(2)=0.939,P=0.192);治疗后症候积分比治疗前低,且B组低于A组,差异有统计学意义(P<0.05);随访3个月,B组复发率(4.44%)低于A组(10.87%),差异无统计学意义(P>0.05);随访6个月后,B组复发率(11.11%)低于A组(28.26%),差异有统计学意义(P<0.05);B组不良反应发生率(6.67%)较A组(17.39%)低,差异有统计学意义(P<0.05)。结论 Hp阳性慢性胃炎活动期患者经序贯药物方案治疗,可提高Hp根除率,改善临床症状,降低复发率,且安全性高。

Objective To study the influence of sequential drug regimen and quadruple therapy on the eradication rate and recurrence of helicobacter pylori(HP)in patients with HP positive chronic gastritis.Methods 91 patients with HP positive chronic gastritis in active stage those admitted to our hospital between August 2018 and November 2019 were enrolled as study subjects,and they were divided into group A(n=45)and group B(n=46)according to double blind method.Group A was treated with quadruple therapy and group B with sequential drug regimen.The HP eradication rate,symptom score,recurrence rate at 3 rdand 6 thmonths,and adverse reactions during treatment were compared between the two groups.Results There were 39 cases of HP eradication in group A(84.78%),42 cases of HP eradication in group B(93.33%),the eradication rate in group B was higher than that in group A(χ^(2)=0.939,P=0.192).The symptom score after treatment was lower than that before treatment,and that in group B was lower than the control group,the difference was statistically significant(P<0.05).After 3 monthsof follow up,the recurrence rate in group B was lower than that in group A(4.44%),however,the difference was not statistically significant(P>0.05).After 6 months of follow-up,the recurrence rate of group B(11.11%)was lower than that of group A(28.26%),the difference was statistically significant(P<0.05).The incidence of adverse reactions of group B(6.67%)was lower than that of group A(17.39%),the difference was statistically significant(P<0.05).Conclusions The sequential drug therapy for patients with HP positive chronic gastritiscould improve the eradication rate of HP,improve the clinical symptoms,reduce the recurrence rate,and has high safety.