不同剂量埃索美拉唑三联疗法根除幽门螺杆菌的临床研究

目的 比较不同剂量埃索美拉唑三联疗法根除幽门螺杆菌(Hp)的临床疗效.方法 将240例Hp阳性患者随机分为两组,A组120例给予埃索美拉唑镁肠溶片40 mg,阿莫西林1 g,克拉霉素500mg,每日2次,共7d;B组120例给予埃索美拉唑镁肠溶片20mg,阿莫西林1 g,克拉霉素500 mg,每日2次,共7 d.疗程结束后4周复查Hp.结果 A组114例患者获随访,其中Hp根除成功104例,意愿分析根除率为86.7%(104/120),按方案分析根除率为91.2%(104/114);B组113例患者获随访,其中Hp根除成功101例,意愿分析根除率为84.2%(101/120),按方案分析根除率为89.4%(101/113),差异均无统计学意义.所有患者均未发生严重的不良反应,A组不良反应发生率为8.3%(10/120),B组为6.7%(8/120),差异无统计学意义.结论 在中国人群中高剂量和低剂量埃索美拉唑的三联疗法根除Hp的成功率并无差异,提示增加埃索美拉唑剂量并不能显著增加Hp根除率.

The clinical research of different dose of esomeprazole-based triple therapies for Helicobacter pylori eradication

Objective To compare the efficacy of different dose esomeprazole-based triplen therapies for Helicobacter pylori (Hp)eradication. Methods Two hundred and forty Hp-infected patients were randomly assigned to undergo high-dose (40 mg) or low-dose (20 mg) esomeprasole combined with clarithromycin (500 mg) and amoxicillin (1g) twice a day for one week. Hp eradication test was performed at 4 weeks after the end of treatment to evaluate the response to therapy. Results One hundred and fourteen patients were followed up in high-dose patients, and 104 were Hp eradication. One hundred and thirteen patients were followed up in low-dose patients, and 101 were Hp eradication. There was no significant difference in eradication rate of intention-to treat analysis and per protocol analysis between high-dose and low-dose patients 86.7%(104/120) vs 84.2% (101/120) and 91.2% (104/114) vs 89.4% (101/113), P>0.05]. There was no significant difference in the rate of adverse effect between high-dose and low-dose patients (8.3%(10/120)vs 6.7%(8/120), P>0.05). Conclusion It demonstrates that low-dose esomeprazole-based triple therapy has a similar Hp eradication rate compared with high-dose esomeprazole-based therapy in China.