链霉蛋白酶联合四联方案在根除幽门螺杆菌失败补救治疗中的应用效果

Application effect of protease combined with quadruple therapy in the remedial treatment of Helicobacter pylori eradication failure

目的观察链霉蛋白酶联合四联方案在根除幽门螺杆菌(Hp)失败补救治疗中的应用效果。方法选取Hp感染初始治疗失败的100例患者为研究对象。100例患者分为对照组(50例)和观察组(50例),2组接受为期14 d的治疗。对照组给予艾司奥美拉唑肠溶片、阿莫西林胶囊、呋喃唑酮片、胶体果胶铋胶囊。观察组在对照组基础上给予链霉蛋白酶颗粒及碳酸氢钠散。计算意向治疗(ITT)分析和符合方案(PP)分析时Hp的根除率。记录2组治疗前后的症状及药物不良反应情况。结果对照组中18例成功根除,ITT分析根除率为36%,PP分析根除率为36%。观察组中,37例患者的14C呼气试验结果呈阴性,ITT分析的根除率为74%,TT分析根除率为74%。2组根除率比较,差异有统计学意义(P<0.05)。2组依从性比较,差异无统计学意义(P>0.05)。2组根除前后腹痛症状改善情况比较,差异有统计学意义(P<0.05)。2组药品的不良反应情况比较,差异无统计学意义(P>0.05)。结论链霉蛋白酶联合四联疗法的补救治疗方案可提高初次根除失败的Hp感染患者的根除率。

Objective To observe the application effect of protease combined with quadruple therapy in the remedial treatment of Helicobacter pylori(Hp)eradication failure.Methods A total of 100 patients with Hp infection who failed in initial treatment were selected as the study objects,and were divided into control group(50 cases)and observation group(50 cases),and two groups received a course of treatment for 14 days.The control group was given esomeprazole enteric-coated tablets,amoxicillin capsules,furazolidone tablets and colloidal bismuth pectin capsules.The observation group was given streptomycin granule and sodium bicarbonate powder on the basis of the control group.Hp eradication rates were calculated for intention to treat(ITT)analysis and per protocol(PP)analysis.The symptoms and adverse drug reactions before and after treatment were recorded in two groups.Results In the control group,18 cases were successfully eradicated,the eradication rate by ITT analysis was 36%,and the eradication rate by PP analysis was 36%.In the observation group,37 patients had negative 14 C breath test results,with an eradication rate of 74%by ITT analysis and 74%by TT analysis.There was statistical significance in the eradication rate between the two groups(P<0.05).There was no significant difference in compliance between the two groups(P>0.05).The improvement of abdominal pain symptoms before and after eradication was statistically significant between the two groups(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion The remedial treatment regimen of streptomycin combined with quadruple therapy can improve the eradication rate of Hp infection patients whose initial eradication failed.