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目的:探讨四联疗法和序贯疗法根除幽门螺杆菌的疗效和安全性。方法:将150例14C尿素呼气试验阳性的慢性胃炎患者随机分为A、B、C 3组各50例。A组(四联疗法)给予雷贝拉唑、枸橼酸铋钾、克拉霉素、阿莫西林治疗7 d;B组(序贯疗法)前5d给予雷贝拉唑、阿莫西林,后5d给予雷贝拉唑、克拉霉素、甲硝唑治疗;C组(标准三联疗法)给予雷贝拉唑、克拉霉素、阿莫西林治疗治疗7 d。疗程结束4周后行14C尿素呼气试验检测。结果:A组根除率为94%,B组根除率为90%,C组根除率68%。A组和B组优于C组(P<0.01);A组、B组无显著差异性(P>0.05)。三组均无严重不良反应。结论:四联疗法与序贯疗法H.pylori根除率优于标准三联疗法,四联疗法和序贯疗法疗效无明显差异性。
Objective: To investigate the efficacy and safety of quadruple therapy and sequential therapy in the eradication of Helicobacter pylori. Methods: One hundred and fifty patients with chronic gastritis positive for 14 C urea breath test were randomly divided into A, B and C groups of 50 cases. Rabeprazole, bismuth potassium citrate, clarithromycin and amoxicillin were given for 7 days in group A (quadruple therapy); rabeprazole and amoxicillin were given 5 days before group B (sequential therapy) Rabeprazole, clarithromycin and metronidazole were given on the 5th day. Rabbits in group C (standard triple therapy) were given rabeprazole, clarithromycin and amoxicillin for 7 days. Four weeks after the end of treatment line 14C urea breath test. Results: The eradication rate was 94% in group A, 90% in group B and 68% in group C. Group A and group B were better than group C (P <0.01). There was no significant difference between group A and group B (P> 0.05). No serious adverse reactions in the three groups. Conclusion: The quadruple and sequential H.pylori eradication rates outweigh the standard triple therapy, with no significant difference between quadruple and sequential therapy.