头孢呋辛和阿莫西林对幽门螺杆菌根除治疗的效果比较

Comparison of efficacy of Cefuroxime and Amoxicillin in the eradication treatment of Helicobacter pylori

目的比较头孢呋辛和阿莫西林分别用于幽门螺杆菌(Hp)根除治疗的效果和安全性。方法选取2017年12月至2020年7月于广西壮族自治区柳州市人民医院门诊确诊为Hp感染的160例患者为研究对象,其中既往未曾行根除Hp治疗的初治患者80例,曾行14 d铋剂四联方案根除Hp治疗失败的复治患者80例。按随机数字表法分为初治头孢呋辛组、初治阿莫西林组、复治头孢呋辛组、复治阿莫西林组,每组40例。在雷贝拉唑、呋喃唑酮、胶体果胶铋的基础上,分别联用头孢呋辛或阿莫西林根除Hp治疗,停药4周后复查Hp,比较各组Hp根除率和不良反应发生率。结果初治头孢呋辛组和初治阿莫西林组Hp根除率比较,差异无统计学意义(P>0.05);复治头孢呋辛组和复治阿莫西林组Hp根除率比较,差异无统计学意义(P>0.05)。各组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论含头孢呋辛与含阿莫西林的四联疗法的Hp根除率无明显差异,无论是初治还是复治均取得了相似的根除率,对于不适合使用青霉素的部分患者,头孢呋辛可能是阿莫西林的良好替代药物。

Objective To compare the efficacy and safety of Cefuroxime and Amoxicillin in the eradication treatment of Helicobacter pylori(Hp).Methods A total of 160 patients diagnosed with Hp infection in the Outpatient Department of Liuzhou People’s Hospital of Guangxi Zhuang Autonomous Region from December 2017 to July 2020 were selected as the research subjects.Among them,80 were initially treated patients who had not received previous Hp eradication treatment,and 80 patients were treated with bismuth drug quadruple regimen for 14 days to eradicate Hp after treatment failure.According to random number table method they were divided into treated first Cefuroxime,first Amoxicillin group and re-treat Cefuroxime and re-treat Amoxicillin group,with 40 cases in each group.Based on Rabeprazole,Furazolidone,and Colloidal bismuth pectin,combination respectively Cefuroxime or Amoxicillin Hp eradication therapy,treatment discontinuation ended at least four weeks after the review of Hp.The eradication rate of Hp and the incidence of adverse reactions in each group were compared.Results There was no significant difference in the eradication rate of Hp between first Cefuroxime group and first Amoxicillin group(P>0.05).There was no significant difference in the eradication rate of Hp between the re-treat Cefuroxime group and the re-treat Amoxicillin group(P>0.05).There was no statistical significance in the total incidence of adverse reactions among all groups(P>0.05).Conclusion There is no significant difference in the eradication rate of Hp between the quadruple therapy containing Cefuroxime and Amoxicillin,and similar eradication rates are obtained for both initial treatment and retreatment.For some patients who are not suitable for Penicillin,Cefuroxime may be a good alternative to Amoxicillin.