含克拉霉素缓释片铋剂四联疗法初次根除幽门螺杆菌的临床疗效

Clinical Efficacy of Quadruple Regimen Including Clarithromycin Sustained-Release Tablets for Primary Eradication of Helicobacter Pylori

目的 探讨克拉霉素缓释片初次根除幽门螺杆菌的临床疗效。方法 回顾性分析2019年1月—2020年12月浙江省立同德医院门诊收治的幽门螺杆菌初次根除患者资料,按克拉霉素剂型选择及用量不同分为3组,即克拉霉素片500 mg bid治疗组(A组)、克拉霉素缓释片500 mg bid治疗组(B组)和克拉霉素缓释片500 mg qd治疗组(C组)。各组治疗结束≥4周后,电话随访并比较分析不同治疗方案根除的有效率、依从性、复发率、不良反应发生率及成本-效果比。结果剔除失访后,共350例纳入本研究,其中A组132例,B组101例,C组117例,各组总体根除率分别为95.45%、92.08%、97.44%。剔除低依从性患者6例(A组3例,B组3例,C组0例),根除率分别为95.35%、92.86%、97.44%。各组间根除率、依从性、复发率及不良反应发生率均无显著性差异,但C组成本-效果比最低。以A组为参照,C组增量成本-效果比为-156.459。结论 克拉霉素缓释片可安全有效地用于幽门螺杆菌感染患者的初次根除治疗,治疗时可按说明书推荐用量使用。

OBJECTIVE To explore the clinical efficacy of clarithromycin sustained-release tablets in the primary eradication of Helicobacter pylori.METHODS Retrospective analysis of the data of patients with primary eradication of Helicobacter pylori admitted to the outpatient department of Tongde Hospital of Zhejiang Province from January 2019 to December 2020 was conducted.They were divided into three groups according to the choice of clarithromycin dosage form and dosage,namely,clarithromycin tablets 500 mg bid treatment group(group A),clarithromycin sustained-release tablets 500 mg bid treatment group(group B),and clarithromycin sustained-release tablets 500 mg qd treatment group(group C).At least 4 weeks after the end of treatment in each group,telephone follow-up was conducted to compare and analyze the efficacy,compliance,recurrence rate,incidence of adverse reactions,and cost effectiveness ratio of different treatment schemes for eradication.RESULTS After eliminating lost visits,a total of 350 cases were included in this study,including 132 cases in group A,101 cases in group B,and 117 cases in group C.The overall eradication rates in each group were 95.45%,92.08%,and 97.44%,respectively.Six patients with low compliance were excluded(3 in group A,3 in group B,and 0 in group C),with eradication rates of 95.35%,92.86%,and 97.44%,respectively.There was no significant difference in the eradication rate,compliance,recurrence rate,and incidence of adverse reactions among the groups,but the cost effectiveness ratio in group C was the lowest.Taking group A as a reference,the incremental cost effectiveness ratio for group C was‒156.459.CONCLUSION Clarithromycin sustained-release tablets can be safely and effectively used in the primary eradication treatment of patients with Helicobacter pylori infection,and can be used according to the recommended dosage in the instructions.