| 束庆文,余海,叶献词,等.铋剂四联疗法根除幽门螺杆菌疗效研究[J].安徽医药,2018,22(1):135-138. |
| 铋剂四联疗法根除幽门螺杆菌疗效研究 |
| Effect of bismuth-based quadruple therapy on Helicobacter pylori eradication |
| 投稿时间：2016-12-06 |
| DOI： |
| 中文关键词: 幽门螺杆菌 根除 疗效 成本-效果分析 |
| 英文关键词: helicobacter pylori eradication therapeutic effect cost-effectiveness analysis |
| 基金项目:铜陵市卫生局2014年科研立项项目(卫科研[2014]23号) 作者简介:束庆文,男,教授,硕士生导师,研究方向:消化系统疾病的临床诊治及消化内镜的诊疗,E-mail:shuqingwen1966@163.com铋剂四联疗法根除幽门螺杆菌疗效研究束庆文a,余海a,叶献词a,汪斌a,林天增b,糜叶俊c,程四八a,刘太平a,钟平d (铜陵市人民医院a.消化内科,b.核医学科,c.病理科,d.科教科,安徽 铜陵 244000)铋剂四联疗法根除幽门螺杆菌疗效研究束庆文a,余海a,叶献词a,汪斌a,林天增b,糜叶俊c,程四八a,刘太平a,钟平d Effect of bismuth-based quadruple therapy on Helicobacter pylori eradicationSHU Qingwena,YU Haia,YE Xiancia,WANG Bina,LIN Tianzengb,MI Yejunc, CHENG Sibaa,LIU Taipinga,ZHONG Pingd |
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| 中文摘要: |
| 目的比较不同疗程铋剂四联疗法与经典三联疗法根除幽门螺杆菌(Hp)的疗效。方法 选择403 例符合条件的Hp阳性的消化性溃疡或慢性胃炎患者。随机分为三组,其中A 组138 例、B 组142 例、C 组123 例。A组采用果胶铋200 mg+雷贝拉唑10 mg+阿莫西林1 000 mg+呋喃唑酮100 mg,2次/天,共10 d；B组采用果胶铋200 mg+雷贝拉唑10 mg+阿莫西林1 000 mg+呋喃唑酮100 mg,2次/天,共14 d；C组采用雷贝拉唑10 mg+阿莫西林1 000 mg+呋喃唑酮100 mg,2次/天,共14 d。观察三组患者Hp根除率、不良反应发生率及其成本-效果比。结果 A、B、C三组患者Hp根除率分别为83.33%、83.80%、71.54%,A组与B组Hp根除率比较差异无统计学意义(P>0.05),A组与C组、B组与C组Hp根除率比较均差异有统计学意义(P<0.05)。A、B、C三组患者的不良反应发生率分别为 1.45%、2.11%、0.81%,均差异无统计学意义(P>0.05)。A、B、C三组成本-效果比分别为1.50、2.09、2.04。结论 三种治疗方案均未达到Hp根除率>90%的理想方案。但三种方案的比较中含铋剂10 d与14 d四联疗法Hp根除率较高,接近理想方案。含铋剂10 d四联疗法成本-效果比最好,建议临床使用。14 d三联疗法Hp根除率仅达71.54%,远低于理想标准,不建议临床使用。 |
| 英文摘要: |
| Objective To compare the efficacy of bismuth-based quadruple therapy for different courses and classic triple therapy in the eradication of Helicobacter pylori (Hp). Methods Four hundred and three patients with Hp-positive peptic ulcer or chronic gastritis were randomly assigned into group A (n=138),group B (n=142) and group C (n=123).Patients in group Awere treated with colloidal bismuth pectin 200 mg+rabeprazole 10 mg+amoxicillin 1 000 mg+furazolidone 100 mg twice daily for 10 days.Patients in group Bwere treated with colloidal bismuth pectin 200 mg+rabeprazole 10 mg+amoxicillin 1 000 mg+furazolidone 100 mg twice daily for 14 days.Patients in group Cwere treated with rabeprazole 10 mg+amoxicillin 1 000 mg+furazolidone 100 mg twice daily for 14 days.Hp eradication rate,incidence of adverse events and cost-effectiveness ratio were analyzed among the three groups. Results The Hp eradication rates of group A,B and Cwere 83.33%,83.80%,and 71.54%,respectively.There was no significant difference in the Hp eradication rate between group Aand B (P>0.05).The Hp eradication rate of group Aand group Bwas higher than group C(P<0.05).The incidences of adverse events of group A,B and Cwere 1.45%,2.11%,and 0.81%,respectively.No significant difference was observed among the three groups (P>0.05).Cost-effectiveness ratio (C/E) of group A,B and Cwere 1.50,2.09,and 2.04,respectively. Conclusions Although the Hp eradication rates of the three treatment regimens are lower than 90%,they are relatively higher in patients treated with bismuth-based quadruple therapy for 10 days and 14 days compared with patients treated with classic triple therapy.Bismuth-based quadruple therapy for 10 days is recommended because of its highest cost-effectiveness ratio.With the lowest Hp eradication rate among these three groups,classic triple therapy for 14 days is not recommended. |
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