二联疗法用于幽门螺杆菌初次治疗的研究进展

Research Progress on Dual Therapy in Primary Treatment of Helicobacter pylori Infection

目前幽门螺杆菌(Hp)的全球感染率仍很高。铋剂四联方案是各大国际共识/指南推荐的根除Hp的一线治疗方案,但服药种类和数量多,不良反应发生率相对较高,导致患者依从性下降。在这一背景下,近年多项研究表明耐药率很低且对酸敏感的阿莫西林联合高剂量质子泵抑制剂(PPI)二联疗法的根除率与主流方案相当,并具有不良事件更少、方案更简单、依从性更好的优势。然而目前二联疗法中的药物剂量和给药频率多样,无法形成共识。本文对各种不同二联疗法进行综述,旨在为确定最佳剂量、给药频率和疗程以及规范二联疗法提供依据。

At present,the global prevalence of Helicobacter pylori( Hp) infection is still high. Although bismuthcontaining quadruple regimens are recommended by international consensus and guidelines as a first-line treatment for Hp infection,the compliance is decreasing due to more drugs needed and higher adverse events. In recent years,many studies on eradication regimen containing high-dose proton pump inhibitor( PPI) and amoxicillin,a low-resistance and acid-labile antibiotic,demonstrated that the dual therapy could achieve high eradication rate equivalent to the mainstream fist-line therapies and had the advantages of less adverse events,simpler drug composition and higher compliance. However,there are discrepancies in dosage and frequencies of drugs in dual therapies,and cannot reach a unified regimen. This article reviewed all kinds of the dual therapy regimens,which might be helpful for determining the optimal dosage,frequencies,and treatment course,so as to standardize the dual therapy.