论文部分内容阅读
目的:比较不同三联疗法治疗幽门螺杆菌(H.pylori)的疗效,筛选效价比较高的根除方案。方法:将117例有消化不良症状经胃镜诊断为胃溃疡或十二指肠球溃疡或活动性慢性胃炎且伴有H.pylori感染的患者随机分为四组进行根除治疗,EAC组:埃索美拉唑、阿莫西林、克拉霉素14d,EAT组:埃索美拉唑、阿莫西林、替硝唑14d,ECT组:埃索美拉唑、克拉霉素、替硝唑14d,BECT组:枸橼酸铋钾、埃索美拉唑、克拉霉素、替硝唑14d。所有患者停药至少4周后复查13C尿素酶呼气试验,判断H.pylori根除情况。结果:(1)EAC组H.pylori根除率为90.00%(27/30),EAT组86.21%(25/29),ECT组56.67%(17/30),BECT组75.00%(21/28),EAC组与EAT组的H.pylori根除率无统计学差异,EAC组和EAT组H.pylori根除率较ECT组明显增高(P分别为0.004和0.012),BECT组H.pylori根除率较EAC组低,较ECT组高,但无统计学差异。(2)EAC、EAT、ECT、BECT组不良反应发生率分别为7/30(23.33%)、5/29(17.24%),9/30(30.00%),9/28(32.14%),各组间比较无统计学差异;(3)EAC组费用为628.87元,EAT组为404.45元,ECT组为585.22元,BECT组为623.01元,EAT组费用最低。结论:14d的含有阿莫西林的三联组合即埃索美拉唑、阿莫西林、替硝唑及埃索美拉唑、阿莫西林、克拉霉素H.pylori根除率较高,不良反应轻微,均可作为根除H.pylori的一线方案,前者效价比更高。14d的埃索美拉唑、克拉霉素、替硝唑三联组合根除率低,联合铋剂组成四联方案根除率有增高趋势。
Objective: To compare the curative effect of different triple therapy in the treatment of H.pylori and to screen out a highly effective eradication program. Methods: A total of 117 patients with dyspeptic symptoms diagnosed as gastroduodenal ulcer or duodenal ulcer or active chronic gastritis with H.pylori infection were randomly divided into four groups. EAC group: Esso Melazoline, amoxicillin, clarithromycin 14d, EAT group: esomeprazole, amoxicillin, tinidazole 14d, ECT group: esomeprazole, clarithromycin, tinidazole 14d, BECT Group: bismuth potassium citrate, esomeprazole, clarithromycin, tinidazole 14d. All patients were stopped for at least 4 weeks after the review 13C urease breath test to determine the eradication of H. pylori. Results: (1) The eradication rates of H.pylori in EAC group were 90.00% (27/30), 86.21% (25/29) in EAT group, 56.67% (17/30) in ECT group and 75.00% (21/28) in BECT group . The eradication rates of H.pylori between EAC group and EAT group were not statistically different. The eradication rates of H.pylori in EAC group and EAT group were significantly higher than those in ECT group (P = 0.004 and 0.012, respectively). The eradication rate of H.pylori in BECT group was significantly higher than that in EAC group Group low, higher than the ECT group, but no significant difference. (2) The incidences of adverse reactions in EAC, EAT, ECT and BECT groups were 7/30 (23.33%), 5/29 (17.24%), 9/30 (30.00%) and 9/28 (3) The cost of EAC group was 628.87 yuan, that of EAT group was 404.45 yuan, that of ECT group was 585.22 yuan, that of BECT group was 623.01 yuan, and that of EAT group was the lowest. Conclusions: The 14-day triple combination of amoxicillin, ie esomeprazole, amoxicillin, tinidazole and esomeprazole, amoxicillin and clarithromycin has a high eradication rate with mild adverse reactions , Can be used as a first-line eradication program H.pylori, the former price is higher. The eradication rate of esomeprazole, clarithromycin and tinidazole for 14 days was low, and the eradication rate of the combination program of bismuth and bismuth increased.