含艾司奥美拉唑和呋喃唑酮四联疗法补救治疗幽门螺杆菌的疗效及安全性

Efficacy and safety of quadruple therapy with esomeprazole and furazolidone in the remedial treatment of Helicobacter pylori

目的观察含艾司奥美拉唑和呋喃唑酮四联疗法对幽门螺杆菌(Hp)补救治疗的疗效和安全性。方法选择2018年1月-2019年12月于河北医科大学附属邢台市人民医院收治的首次Hp根除失败的患者152例,采用随机数字表法分为观察组76例和对照组76例。观察组采用艾司奥美拉唑、阿莫西林、呋喃唑酮、胶体果胶铋四联疗法治疗,对照组采用泮托拉唑、阿莫西林、呋喃唑酮、胶体果胶铋四联疗法治疗,2组疗程均为14 d。治疗结束4周后行^(13)C-尿素呼气试验(^(13)C-UBT)或^(14)C-尿素呼气试验(^(14)C-UBT),判断Hp的根除情况;比较2组患者治疗前后血白细胞计数(WBC)、血小板计数(PLT)、丙氨酸氨基转移酶(ALT)、肌酐(Cr)水平及不良反应。结果观察组患者Hp根除率按意向性(ITT)分析为82.6%,高于对照组患者的67.2%(χ^(2)=4.173,P=0.041),Hp根除率按符合方案(PP)分析为89.9%,高于对照组的76.1%(χ^(2)=4.564,P=0.033)。治疗前后2组患者血WBC、PLT、ALT、Cr水平比较差异均无统计学意义(P>0.05)。2组患者不良反应总发生率比较差异无统计学意义(χ^(2)=0.379,P=0.538),均未见严重不良反应。结论采用含艾司奥美拉唑和呋喃唑酮四联疗法补救治疗Hp可获取较高的根除率,且安全性良好。

Objective To observe the efficacy and safety of quadruple therapy containing esomeprazole and furazolidone in the remedial treatment of Helicobacter pylori(Hp).Methods A total of 152 patients who failed to eradicate Hp for the first time in Xingtai People’s Hospital affiliated to Hebei Medical University from January 2018 to December 2019 were selected.Using random number table method,they were divided into observation group and control group,each of 76 cases.The observation group was treated with esomeprazole,amoxicillin,furazolidone and colloidal pectin bismuth quadruplex therapy,while the control group was treated with pantoprazole,amoxicillin,furazolidone and colloidal pectin bismuth quadruplex therapy,the treatment course of both groups lasted for 14 days.Four weeks after treatment,^(13)C-urea breath test(^(13)C-UBT) or^(14)C-urea breath test(^(14)C-UBT) was performed to determine Hp eradication.WBC,PLT,ALT,Cr levels and adverse reactions were compared between 2 groups before and after treatment.Results The eradication rate of Hp in the observation group was82.6%,higher than 67.2%in the control group(χ^(2)=4.173,P=0.041).The eradication rate of Hp by PP analysis was89.9%,higher than 76.1%in control group(χ^(2)=4.564,P=0.033).There were no significant differences in blood WBC,PLT,ALT and Cr levels between 2 groups before and after treatment(P>0.05).There was no significant difference in the total incidence of adverse reactions between 2 groups(χ^(2)=0.379,P=0.538),and no serious adverse reactions were observed.Conclusion Quadruple therapy with esomeprazole and furazolidone can achieve high eradication rate and good safety.