| 王俊先.幽门螺杆菌首次根除失败后两种补救方案的疗效观察[J].安徽医药,2016,20(9):1744-1746. |
| 幽门螺杆菌首次根除失败后两种补救方案的疗效观察 |
| Clinical efficacy of two different rescue therapy for the Helicobacter pylori after the first failure of eradication |
| 投稿时间：2016-04-13 |
| DOI： |
| 中文关键词: 幽门螺杆菌 抗药性,细菌 呋喃唑酮 四环素 氧氟沙星 阿莫西林 雷贝拉唑 胶体果胶铋 方案评价 |
| 英文关键词: |
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| 中文摘要: |
| 目的 观察含呋喃唑酮及四环素的四联疗法和含左氧氟沙星及阿莫西林的四联疗法对首次幽门螺杆菌(Hp)根除失败后的补救根除治疗的疗效。方法 收集首次根除失败Hp感染者136例。随机数字表法分为治疗组66例、对照组70例。治疗组治疗方案为:雷贝拉唑20 mg,2次/d;胶体果胶铋300 mg,2次/d;四环素750 mg,2次/d;呋喃唑酮 100 mg,2次/d。对照组的治疗方法为:雷贝拉唑20 mg,2次/d;胶体果胶铋胶囊300 mg,2次/d;左氧氟沙星500 mg,1次/d;阿莫西林1 000 mg,2次/d。两组均治疗14 d。观察两种治疗方案根除的率,并随访观察患者在治疗过程中出现的不良反应。结果 两组患者在治疗结束后1月复查14C呼气试验。治疗组有61例复查,57例为阴性,符合方案集(PP)分析根除率为93.4%,意向性治疗原则(ITT)分析根除率为86.4%；对照组有64例复诊,51例为阴性,PP分析根除率为79.7%,ITT分析根除率为72.9%。两组PP分析根除率及ITT根除率均差异有统计学意义(P=0.022、 P=0.041)。治疗组随访的61例共有6例出现不良反应,不良反应发生率为9.83%；对照组64例中,有8例发生不良反应,不良反应发生率为12.5%。两组差异无统计学意义(P=0.426)。结论 含呋喃唑酮及四环素的四联疗法对于首次Hp根除失败患者行再根除治疗仍然有效,可以做为Hp的补救根治的治疗方案之一。而含阿莫西林及左氧氟沙星四联疗法对首次Hp根除失败者补救根除疗效欠佳,不推荐用于Hp的补救根除治疗。 |
| 英文摘要: |
| Objective To observe the efficacy of two quadruple therapy in which Furaxone combined with Tetracycline and Levofloxacin combined with Amoxicillin in treating the patients undergoing remedial eradication therapy after the first failure of H.pylori eradication.Methods 136 cases of patients with positive Hp infection undergoing first eradication failure,which was verified by 14C breath test,were collected.These cases were randomized into 2 groups.There were 66 cases in treatment group and 70 cases in control group.The therapeutic plan in treatment group included Rabeprazole at the dose of 20 mg a time,2 times per day;colloidal bismuth pectin capsules at the dose of 300 mg a time,2 times per day;tetracycline at the dose of 750 mg a time,2 times per day;furazolidone at the dose of 100 mg a time,2 times per day.Patients in control group were administered with rabeprazole 20 mg a time,2 times per day;amoxicillin 1 000 mg a time,2 times per day;colloidal bismuth pectin capsules 300 mg a time,2 times per day,and levofloxacin at the dose of 500 mg a time,1 time per day.Two groups both were treated for 14 days.The PP analysis eradication rate and the ITT analysis eradication rate in both groups were compared and the adverse reactions occurring during the course of treatment were followed up.Results 14C breath test was reviewed in both two groups of patients 1 month after the treatment.Sixty-one cases were reviewed in the treatment group,and 57 cases were negative for Hp.The eradication rates were 93.4% and 86.4% respectively with per-protocol(PP) analysis and intention-to-treat(ITT) analysis.Sixty-four cases were reviewed in the control group with 51 negative cases.The eradication rates with PP analysis and ITT analysis were 79.7% and 72.9% respectively.There were statistically significant differences in eradication rates of both groups with PP analysis and ITT analysis(P=0.022 vs P=0.041).In the treatment group,61 cases were followed up and 6 cases(9.83%) had adverse reactions,while in the control group,8 cases(12.5%) had adverse reactions.There was no significant difference between the two groups(P=0.426).Conclusions Furaxone and Tetracycline containing quadruple therapy still has efficacy on the patients who underwent re-eradication therapy after first eradication failure of H.Pylori,which could be one of the treatment options for remedial cure of H.pylori.Levofloxacin and amoxicillin containing quadruple therapy shows weak clinical effects,therefore,it cannot be recommended as the preferred remedial option for patients with first failure of H.pylori eradication. |
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