三种疗法在幽门螺杆菌阳性患者中的应用效果比较

Comparison of application effect of three therapies in Helicobacter pylori positive patients

目的探讨铋剂四联疗法、序贯疗法、伴同疗法在幽门螺杆菌(Hp)阳性患者中的应用效果。方法选取2019年3月至2021年3月于南通市通州区人民医院就诊的127例消化性溃疡与慢性胃炎患者为研究对象,所有患者接受胃镜检查确诊,且通过14C尿素呼气试验检测方法确诊Hp阳性,按照随机数字表法分为铋剂四联疗法组(n=43)、序贯疗法组(n=42)及伴同疗法组(n=42)。比较三组患者治疗后的Hp根除率、临床症状的改善状况以及不良反应总发生率。结果意向性分析结果显示,序贯疗法组、铋剂四联组、伴同疗法组的Hp根除率分别为69.05%、79.07%、85.71%,三组患者的Hp根除率比较,差异无统计学意义(P>0.05)。符合方案集结果显示,序贯疗法组、铋剂四联疗法组、伴同疗法组的Hp根除率分别为73.68%、87.5%、94.87%,三组的Hp根除率比较,差异有统计学意义(P<0.05),其中伴同疗法组的Hp根除率高于序贯疗法组,差异有统计学意义(P<0.017)。治疗前三组患者的症状评分比较,差异无统计学意义(P>0.05);治疗后,三组患者的症状评均高于治疗前,差异有统计学意义(P<0.05),但三组间患者的症状评分比较,差异无统计学意义(P>0.05)。序贯治疗组、铋剂四联疗法组、伴同治疗组患者治疗后的不良反应总发生率分别为19.05%(8/42)、16.28%(7/43)、38.1%(16/42),三组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论伴同疗法的Hp根除率最佳,三种疗法对症状改善效果相当,且安全性均较高。

Objective To explore the application effect of bismuth containing quadruple therapy,sequential therapy and concomitant therapy in Helicobacter pylori(Hp)positive patients.Methods A total of 127 patients with peptic ulcer and chronic gastritis treated in Tongzhou District People′s Hospital of Nantong city from March 2019 to March 2021 were selected as the research subjects.All patients were confirmed by gastroscopy and positive for Hp by 14C urea breath test.According to random number table method,they were divided into bismuth quadruple therapy group(n=43),sequential therapy group(n=42)and companion therapy group(n=42).Hp eradication rate,improvement of clinical symptoms and total incidence of adverse reactions were compared among three groups after treatment.Results The results of intentional analysis showed that the Hp eradication rates of the sequential therapy group,the bismuth quadruple group and the companion therapy group were 69.05%,79.07%and 85.71%,respectively.There was no statistical significance in the Hp eradication rates of the three groups(P>0.05).According to the results of the protocol set,the Hp eradication rates of the sequential therapy group,the bismuth quadruple therapy group and the companion therapy group were 73.68%,87.5%and 94.87%,respectively,and the difference of Hp eradication rates among three groups were statistically significant(P<0.05).The Hp eradication rate in the companion therapy group was higher than that in the sequential therapy group,and the difference was statistically significant(P<0.017).There was no statistical significance in symptom scores of the three groups before treatment(P>0.05).After treatment,the symptom scores of patients in the three groups were higher than before,the difference was statistically significant(P<0.05),but there was no statistically significant difference between the symptom scores of patients in the three groups(P>0.05).The total incidence of adverse reactions after treatment was 19.05%(8/42)in the sequential treatment group,16.28%(7/43)in the bismuth quadruple therapy group and 38.1%(16/42)in the companion treatment group,respectively,and there was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion Companion therapy had the best Hp eradication rate,and the three treatments had similar symptom improvement effects with high safety.