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1.
目的 观察雷贝拉唑、克拉霉素、左氧氟沙星、阿莫西林(四联药物)10日序贯疗法根除幽门螺旋杆菌(HP)的疗效及安全性.方法 将经胃镜确诊的消化性溃疡和慢性胃炎伴胃黏膜萎缩或糜烂且幽门螺杆菌阳性的80例成人患者随机分成治疗组和对照组各40例.治疗组前5d口服雷贝拉唑10 mg、阿莫西林1 000 mg,2次/d;后5d口服雷贝拉唑10 mg、克拉霉素500 mg,2次/d;左氧氟沙星500 mg,1次/d.对照组采用传统的三联疗法(雷贝拉唑10 mg、阿莫西林1 000mg、克拉霉素500 mg,2次/d,共10 d).结果 治疗组及对照组HP根除率分别为92.5%(37/40)、75%(30/40),P<O.05;不良反应发生率分别为7.5%、10%,两组相比差异无统计学意义.结论 四联药物10日序贯疗法对成人HP的根除率明显优于传统三联疗法,且较为安全.  相似文献   

2.
改良序贯疗法根除幽门螺杆菌的疗效观察   总被引:1,自引:1,他引:0  
目的探讨雷贝拉唑、阿莫西林、左氧氟沙星、克拉霉素组成的10d序贯疗法根除幽门螺杆菌(Hp)的疗效及安全性。方法将110例Hp阳性患者分成两组,治疗组采用改良序贯疗法;对照组采用标准三联疗法。疗程结束4周后复查碳14呼气试验,观察Hp根除率和不良反应。结果治疗组按意图治疗和按试验方案分析Hp根除率分别为91.7%和94.8%,对照组分别为76.0%和79.1%,两组根除率比较差异有统计学意义(P0.05);治疗组和对照组不良反应分别为2例和3例。结论雷贝拉唑、阿莫西林、左氧氟沙星组成的10d序贯疗法是一种疗效高、不良反应少的Hp根除方案,可以作为治疗Hp感染的一种选择方案。  相似文献   

3.
目的探讨四联疗法与序贯疗法对首次幽门螺杆菌(Helicobacter pylori,H.pylori)根除失败患者的补救治疗的疗效。方法将79例首次H.pylori根除失败患者随机分成2组,A组39例,用序贯方案(前5 d:泮托拉唑+左氧氟沙星,后5 d:泮托拉唑+克拉霉素+替硝唑),B组40例,用四联方案(泮托拉唑+胶体果胶铋+阿莫西林+克拉霉素),A、B两组疗程均为10 d。停药4周后复查14C-尿素呼气试验判断H.pylori根除情况。结果 79例患者中,共75例完成抗根除H.pylori治疗周期及随访。按意向性分析(ITT分析),两组H.pylori感染根除率分别为66.67%、70.00%;按符合方案集分析(PP分析),两组H.pylori感染根除率分别为70.27%、73.68%,差异均无统计学意义(P0.05)。两组不良反应发生率分别为15.4%、10.0%,差异无统计学意义(P0.05)。A组药品成本低于B组药品成本。结论四联疗法(10 d)及含左氧氟沙星的序贯疗法(10 d)均能有效补救首次根除治疗失败的H.pylori感染,而不良反应均不明显,但从药物经济学角度讲,序贯疗法药品成本优于四联疗法药品成本,10 d序贯疗法更适合推广使用。  相似文献   

4.
目的 比较含左氧氟沙星的10 d序贯疗法与7 d标准三联疗法根除幽门螺杆菌(Hp)的疗效.方法 将78例胃、十二指肠溃疡及慢性胃炎伴Hp感染患者,随机分为两组各39例,治疗组前5 d予兰索拉唑30 mg+阿莫西林1 000 mg,2次/d,后5d予兰索拉唑30 mg+左氧氟沙星200 mg+呋喃唑酮100 mg,2次/d;对照组予兰索拉唑30mg+阿莫西林1 000 mg+克拉霉素500mg,2次/d,疗程7d.疗程结束后至少4周复查14 C-UBT,评估治疗结果及不良反应.结果 治疗组Hp根除率为92.3%,对照组为74.3%.治疗组Hp根除率显著高于对照组(P<00.5).两组不良反应发生率无明显差异(P>0.05).结论 含左氧氟沙星的10 d序贯疗法Hp根除率高,疗效优于7 d标准三联疗法.  相似文献   

5.
目的 比较雷贝拉唑、果胶铋、左氧氟沙星、呋喃唑酮组成的四联10d疗法与传统三联疗法根除复发性幽门螺杆菌(Hp)感染的疗效.方法 将经电子胃镜检查确诊为伴胃黏膜萎缩、糜烂的慢性胃炎患者98例随机分为两组:治疗组(A组,50例)方案为雷贝拉唑+果胶秘+左氧氟沙星+呋喃唑酮,疗程10d;对照组(B组,48例),三联疗法为奥美...  相似文献   

6.
目的:观察对比序贯疗法及含左氧氟沙星的四联疗法对首次根除幽门螺杆菌(Helicobacter pylori,H.pylori)失败患者行补救根除时的疗效.方法:自2010-09/2014-05共收集首次根除失败的H.pylori感染患者167例.随机分为2组,序贯治疗组共85例,四联治疗组82例.序贯治疗方法为:前5天予以雷贝拉唑10 mg,2次/d;阿莫西林胶囊1000 mg,2次/d;后5天予以雷贝拉唑10 mg,口服2次/d;克拉霉素分散片500 mg,2次/d;奥硝唑片0.5 g,2次/d.四联治疗方法为:雷贝拉唑10 mg,2次/d;枸橼酸铋钾胶囊300 mg2次/d;左氧氟沙星片0.2 g,2次/d;阿莫西林1000 mg,2次/d.四联药物共服药12 d.观察患者在治疗期间的药物不良反应.结果:治疗结束后1 mo复查14C呼气试验,共有152例患者随访成功.序贯治疗组有77例随访成功,60例为阴性,符合方案集(per-protocol P P)分析根除率为77.92%,意向性治疗原则(intention-to-treat,ITT)分析根除率为70.6%四联治疗组随访成功的75例,有3例发生严重不良反应而退出试验.72中有61例为阴性,PP分析根除率为84.72%,ITT分析根除率为74.4%.两组PP分析根除率及ITT根除率均无统计学差异(60/77与61/72,χ2=1.127,P=0.288;60/85与61/82,χ2=0.302,P=0.582).序贯治疗组随访的77例共有9例出现不良反应不良反应发生率为11.7%.四联治疗组随访的75例中,有11例发生不良反应,不良反应发生率分别为14.7%.两组不良反应发生率差异无统计学意义(χ2=0.295,P=0.587).结论:四联疗法及序贯疗法在对于首次H.pylori根除失败后再根除时的疗效无显著性差异.不推荐将两种疗法作为H.pylori的补救根治首选方案.  相似文献   

7.
含替硝唑序贯疗法根除幽门螺杆菌62例   总被引:1,自引:0,他引:1  
目的: 观察由泮托拉唑、替硝唑、阿莫西林、克拉霉素组成的10日序贯疗法根除幽门螺杆菌( H pylori)的疗效.方法: 将经胃镜检查确诊为慢性胃炎和消化性溃疡且H pylori阳性的患者120例随机分为两组, 治疗组(62例)方案为前5 d给予泮托拉唑+阿莫西林, 后5 d给予泮托拉唑+克拉霉素+替硝唑;对照组(58例)三联疗法为泮托拉唑+阿莫西林+克拉霉素, 疗程7 d. 比较治疗后两组患者H pylori根除率.结果: 治疗组和对照组H pylori ITT根除率分别为83.87%和67.24%, PP根除率分别为89.66%和72.22%, 两组分别有统计学意义( P<0.05).结论: 含替硝唑的10日序贯疗法治疗H pylori感染具有较高的根除率.  相似文献   

8.
[目的]比较四联疗法与序贯疗法在幽门螺杆菌(Hp)根除补救治疗中的疗效及安全性,旨在寻找一种有效、安全、经济的补救治疗方案。[方法]将首次根除Hp治疗失败的90例慢性胃炎患者,随机分为四联疗法组和序贯疗法组,每组45例。四联疗法组患者治疗方案为埃索美拉唑、枸橼酸铋钾、阿莫西林、莫西沙星,疗程14d。序贯疗法组患者治疗方案为前5d给予埃索美拉唑、阿莫西林;后5d给予埃索美拉唑、克拉霉素、奥硝唑。所有患者在疗程结束停药4周后行14 C尿素呼气试验检测Hp。比较2组患者治疗前后的不良反应。[结果]四联疗法组Hp根除率(91.1%)显著高于序贯疗法组(75.6%),差异有统计学意义(P<0.05)。2组不良反应均很轻微,组间不良反应发生率比较差异无统计学意义(P>0.05)。[结论]对于Hp补救治疗,四联疗法较序贯疗法疗效更好,且不良反应小,患者依从性好,值得在临床上推广。  相似文献   

9.
目的:比较铋剂四联组、10 d改良序贯组、14 d改良序贯组补救根除幽门螺旋杆菌(Helicobacter pylori,H.pylori)感染的效果差异.方法:将首次铋剂四联疗法根除H.pylori失败的195例慢性胃炎、消化性溃疡患者,随机分为铋剂四联组、10 d改良序贯组、14 d改良序贯组,每组65例.A组(铋剂四联组)给予雷贝拉唑、阿莫西林、左氧氟沙星、胶体果胶铋;B组(10 d改良序贯组)前5 d予雷贝拉唑、阿莫西林,后5 d予雷贝拉唑、左氧氟沙星、呋喃唑酮;C组(14 d改良序贯组)前7 d予雷贝拉唑、阿莫西林,后7 d予雷贝拉唑、左氧氟沙星、呋喃唑酮.所有患者在疗程结束停药4 wk后行~(14)C尿素呼气试验.记录3组患者药物不良反应.结果:A、B、C组根除率分别为75.4%、89.2%、95.4%,同A组相比,B组根除率(χ~2=0.039,P0.05)和C组根除率(χ~2=0.001,P0.05)明显提高,差异有统计学意义.B组高于C组,差异无统计学意义(χ~2=0.188,P0.05).A组不良反应率为27.7%、B组不良反应率26.2%、C组不良反应率29.2%,差异无统计学意义(P0.05).结论:对于H.pylori补救治疗,改良序贯疗法疗效更好,且不良反应低,推荐14 d改良序贯疗法作为首选方案之一.  相似文献   

10.
目的对比分析标准三联疗法与序贯疗法对幽门螺杆菌(H.pylori)阳性胃溃疡患者的疗效。方法选择2013年2月至2015年12月在我院进行诊治的胃溃疡患者165例,随机分为两组。对照组予以三联疗法(阿莫西林1 000 mg+雷贝拉唑肠溶片20 mg+克拉霉素500 mg,2次/d)进行治疗10 d。观察组予以序贯疗法(前5 d予阿莫西林1 000 mg+雷贝拉唑肠溶片20 mg,2次/d;后5 d予左氧氟沙星200mg+雷贝拉唑肠溶片20 mg+克拉霉素500 mg,2次/d)。比较两组的Glasgow评分、症状评分、H.pylori根除及不良反应情况。结果观察组的H.pylori根除率明显高于对照组(P0.05);两组治疗后的Glasgow评分均明显降低(P0.05),且观察组明显低于对照组(P0.05);两组治疗后的腹胀、腹痛和反酸嗳气评分均明显降低(P0.05),且观察组明显低于对照组(P0.05);观察组便秘、腹泻、乏力、口苦等不良反应发生率明显低于对照组(P0.05)。结论序贯疗法在治疗胃溃疡中改善患者症状,根除H.pylori及良良反应等均优于标准三联疗法,可以作为H.pylori阳性胃溃疡患者的初治首选方案。  相似文献   

11.
AIM: To evaluate the efficacy of sequential vs hybrid therapy in patients with Helicobacter pylori(H. pylori) infection.METHODS: From March 2013 to May 2014,one hundred and seventy-five H. pylori infected patients who had not been treated for H. pylori before wererandomized to receive either sequential therapy(rabeprazole 20 mg and amoxicillin 1 g twice daily for 5 d,followed by rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg twice daily for 5 d) or hybrid therapy(rabeprazole 20 mg and amoxicillin 1 g for 7 d,followed by rabeprazole 20 mg,amoxicillin 1 g,clarithromycin 500 mg and metronidazole 500 mg twice daily for 7 d). H. pylori status was confirmed by positive results of both rapid urease test and histology examination or a positive result of culture. Eradication efficacy was assessed by follow-up endoscopy with rapid urease test and histological examination 8 wk after the end of anti-H. pylori therapy,or 13C-urea breath test at least 4 wk after completion of treatment. The primary outcome was H. pylori eradication by intension-to-treat(ITT) and per-protocol(PP) analyses.RESULTS: One hundred and sixty-seven patients(83 patients in the sequential group and 84 patients in the hybrid group) completed the study. The compliance rates were 97.6% and 97.7% for the two groups,respectively. The eradication rate was 78.2% for the sequential group and 92% for the hybrid group by ITT analysis(P = 0.01). The eradication rate was 81.9% for the sequential group and 96.4% for the hybrid group by PP analysis(P = 0.01). Univariate analysis for the clinical and bacterial factors did not identify any risk factors associated with treatment failure. Severe adverse events were observed in 2.3% of patients in the sequential group and 2.4% of those in the hybrid group.CONCLUSION: Due to a grade A( 95%) success rate for H. pylori eradication by PP analysis,similar compliance and adverse events,hybrid therapy seems to be an appropriate eradication regimen in Taiwan.  相似文献   

12.
目的:观察10d序贯疗法治疗幽门螺杆菌(Helicobacter pylori,H.pylori)的疗效及不良反应,与14d三联标准疗法比较H.pylori根除情况及经济学上有无优越性.方法:将103例经胃镜检查确诊为慢性胃炎或消化性溃疡且H.pylori阳性的患者随机分为两组,治疗组(10d序贯疗法)52例,前5d埃索美拉唑、阿莫西林,后5d埃索美拉唑、克拉霉素、替硝唑.对照组(14d标准三联疗法)51例,埃索美拉唑、阿莫西林、克拉霉素14d.所有患者停药4wk后复查13C呼气试验或胃镜检查,判断H.pylori根除情况.结果:治疗组H.pylori根除率为90.4%,与对照组(90.2%)比较无统计学差异(P=1.000);两组不良反应发生率分别为12/52(23.1%)、18/51(35.3%),两组比较无统计学差异(P=0.172);治疗组费用为380.6元,较对照组(677.88元)明显减低.结论:10d序贯疗法的H.pylori根除率不低于标准14d三联疗法,2组不良反应发生率相似,但10d序贯疗法根除H.pylori的效价比更高.  相似文献   

13.
刘贞  许军英 《临床内科杂志》2011,28(10):678-680
目的比较10天序贯疗法与10天标准三联疗法根除幽门螺杆菌(HP)的疗效,并观察根除HP对反流性食管炎愈合率的影响。方法将76例反流性食管炎合并HP感染的患者随机分为3组:序贯疗法治疗组32例,埃索美拉唑+阿莫西林,每日2次,共用5天,随后5天用埃索美拉唑+克拉霉素+替硝唑,每日2次;三联疗法治疗组24例,埃索美拉唑+克拉霉素+阿莫西林,每日2次,疗程10天,两组抗HP疗程结束后继续给予埃索美拉唑,每日2次,总疗程8周;对照组20例:单用埃索美拉唑,每Et2次,疗程8周。疗程结束后复查胃镜,并行HP检测。结果序贯疗法与三联疗法对幽门螺杆菌的根除率分别为87.50%和58.33%,两组比较差异有统计学意义(P〈0.05)。HP根除患者和未根除患者食管炎治愈率分别为83.33%和91.18%,两者比较差异无统计学意义;3组食管炎的治愈率分别为87.50%、83.33%和90%,三者之间比较差异无统计学意义。结论在食管炎患者中,序贯疗法HP根除率明显优于三联疗法;根除幽门螺杆菌对反流性食管炎8周愈合率无明显影响。  相似文献   

14.
With the rising prevalence of antimicrobial resistance,the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e.,80% or less) in most countries.Therefore,several treatment regimens have emerged to cure Helicobacter pylori (H.pylori) infection.Novel first-line anti-H.pylori therapies in 2011 include sequential therapy,concomitant quadruple therapy,hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy.After the failure of standard triple therapy,a...  相似文献   

15.
AIM: To evaluate the efficacy of moxifloxacin-based sequential therapy(MBST) versus hybrid therapy as a first-line treatment for Helicobacter pylori(H. pylori) infection.METHODS: From August 2014 to January 2015, 284 patients with confirmed H. pylori infection were randomized to receive a 14-d course of MBST(MBST group, n = 140) or hybrid(Hybrid group, n = 144) therapy. The MBST group received 20 mg rabeprazole and 1 g amoxicillin twice daily for 7 d, followed by 20 mg rabeprazole and 500 mg metronidazole twice daily, and 400 mg moxifloxacin once daily for 7 d. The Hybrid group received 20 mg rabeprazole and 1 g amoxicillin twice daily for 14 d. In addition, the Hybrid group received 500 mg metronidazole and 500 mg clarithromycin twice daily for the final 7 d. Successful eradication of H. pylori infection was defined as a negative 13C-urea breath test 4 wk after the end of treatment. Patient compliance was defined as "good" if drug intake was at least 85%. H. pylori eradication rates, patient compliance with treatment, and adverse event rates were evaluated.RESULTS: The eradication rates in the intention-totreat(ITT) analysis were 91.4%(128/140; 95%CI: 90.2%-92.9%) in the MBST group and 79.2%(114/144; 95%CI: 77.3%-80.7%) in the Hybrid group(P = 0.013). The eradication rates in the perprotocol(PP) analysis were 94.1%(128/136; 95%CI: 92.9%-95.6%) in the MBST group and 82.6%(114/138; 95%CI: 80.6%-84.1%) in the Hybrid group(P = 0.003). The H. pylori eradication rate in the MBST group was significantly higher than that of the Hybrid group for both the ITT(P = 0.013) and the PP analyses(P = 0.003). Both groups exhibited full compliance with treatment(MBST/Hybrid group: 100%/100%). The rate of adverse events was 11.8%(16/136) and 19.6%(27/138) in the MBST and Hybrid group, respectively(P = 0.019). The majority of adverse events were mild-to-moderate in intensity; none were severe enough to cause discontinuation of treatment in either group.CONCLUSION: MBST was more effective and led to fewer adverse events than hybrid therapy as a first-line treatment for H. pylori infection.  相似文献   

16.
目的:比较雷贝拉唑、阿莫西林、克拉霉素、奥硝唑组成的8d与10d序贯疗法根除幽门螺杆菌(H.pylori)的疗效.方法:将经胃镜检查确诊为慢性胃炎和消化性溃疡,且H.pylori阳性的217例患者随机分为2组,8d组(n=104)方案:前4d,雷贝拉唑+阿莫西林;后4d,雷贝拉唑+克拉霉素+奥硝唑.10d组(n=113)方案:前5d,雷贝拉唑+阿莫西林;后5d,雷贝拉唑+克拉霉素+奥硝唑.根除治疗后复查14C-尿素呼气试验,比较两组H.pylori根除率.结果:8d组和10d组H.pyloriITT根除率分别为89.3%和91.2%,PP根除率分别为92.0%和93.7%.两种分析方法比较两组的根除率差异均无统计学意义(P>0.05),但8d序贯疗法降低了成本-效果比,减轻了患者的经济负担.两种方案症状缓解率及不良反应发生率的差异无统计学意义(P>0.05).结论:8d序贯疗法可以获得较高的H.pylori根除率和症状缓解率,且经济、安全,是一种可供选择的一线治疗方案.  相似文献   

17.
OBJECTIVE: The aim of this prospective study was to compare the efficacy of the first‐line lansoprazole‐based sequential therapy and concomitant therapy (lansoprazole, amoxicillin, clarithromycin and metronidazole) for Helicobacter pylori (H. pylori) eradication. METHODS: A total of 169 patients with H. pylori infection were randomly assigned to either the sequential therapy group (n = 85) or the concomitant therapy group (n = 84). A follow‐up endoscopy or urea breath test was examined at least 12 weeks after eradication. RESULTS: Comparable H. pylori eradication rate was observed in both the sequential therapy and concomitant therapy groups by either intention‐to‐treat analysis [sequential 80.0% (68/85) vs concomitant 88.1% (74/84); P = 0.27] or per protocol analysis [sequential, 85.3% (64/75) vs concomitant, 94.6% (70/74); P = 0.60]. Adverse effects were reported and good compliance was observed in both groups (P = 0.72). Although dual antibiotics resistance affected the therapeutic efficacy of sequential therapy (P = 0.03), not concomitant therapy (P = 0.74), it was not an independent factor for predicting the treatment outcome. CONCLUSION: First‐line lansoprazole‐based sequential and concomitant therapy were well‐tolerated and comparable in terms of their H. pylori eradication rate.  相似文献   

18.
目的评价在粤东地区采用10d序贯疗法与传统三联疗法治疗幽门螺杆菌(Hp)感染的临床疗效。方法将汕头市、揭阳市、汕尾市经胃镜下胃黏膜Hp快速尿素酶试验阳性或者14C-尿素呼气试验阳性的患者132例,随机分为2组,治疗组67例,采用10d序贯疗法治疗,即前5d口服泮托拉唑20mg+阿莫西林1000mg,bid,后5d泮托拉唑20mg+克拉霉素500mg+甲硝唑400mg,bid。对照组65例,采用标准三联疗法:泮托拉唑20mg+甲硝唑400mg+阿莫西林1000mg,bid,疗程7d。疗程结束后4周行快速尿素酶试验或者14C-尿素呼气试验检测Hp。结果治疗组Hp根除率为94.03%,对照组73.85%,两组比较有显著性差异(P0.05)。结论在粤东地区采用10d序贯疗法对幽门螺杆菌感染的根除率高于传统的7d三联疗法。  相似文献   

19.
Background and Aims: The eradication rate of proton pump inhibitor (PPI)‐based triple therapy for Helicobacter pylori (H. pylori) infection has decreased, mainly due to increasing antibiotic resistance, especially against clarithromycin. It has been reported that a 10‐day sequential strategy can produce good outcomes. The aim of this prospective study was to assess the efficacy of sequential therapy as the first‐line treatment for the eradication of H. pylori in Korea. Methods: A total of 116 patients with proven H. pylori infection received 10‐day sequential therapy (20 mg rabeprazole and 1 g amoxicillin, twice daily for the first 5 days, followed by 20 mg rabeprazole, 500 mg clarithromycin, and 500 mg metronidazole, twice daily for the remaining 5 days); 130 patients received 7‐day triple therapy (20 mg rabeprazole, 500 mg clarithromycin, and 1 g amoxicillin, twice daily for 7 days). Eradication was evaluated by the 13C‐urea breath test, 4 weeks after the completion of treatment. Compliance and adverse events were assessed. Results: The eradication rates of 10‐day sequential therapy and PPI‐based triple therapy were 79.3% (92/116) and 63% (82/130) by intention‐to‐treat analysis, respectively (P = 0.005), and 81.9% (91/111) and 64.5% (82/127) by per protocol analysis, respectively (P = 0.003). Mild adverse events occurred in both therapy groups (27.5% vs 23.8%), but both treatments were well tolerated. Conclusion: The eradication rate of the 10‐day sequential therapy regimen was significantly higher than that of PPI‐based triple therapy in the Korean population. Ten‐day sequential therapy might be effective as a first‐line treatment for H. pylori infection in Korea.  相似文献   

20.
AIM: To compare the one-day quadruple therapy with a standard 7-d triple therapy for H pylori eradication in a rural population of China. METHODS: A total of 396 patients with 13C-urea breath test positive for H pylori were assigned into two groups: 239 patients received one-day quadruple therapy (amox icillin 2000 mg qid; metronidazole 500 mg qid; bismuth citrate 900 mg qid and lansoprazole 60 mg once daily) and 157 patients received 7-d standard triple therapy (amoxicillin 1000 mg bid; clarithromycin 500 mg bid and lansoprazole 30 mg bid). All the patients underwent a 13C-UBT to assess the eradication of H pylori infection six weeks after treatment. RESULTS: Two hundred and twenty-nine patients completed the one-day therapy (95.8%) and 148 patients completed the 7-d therapy (94.2%). The one day therapy eradicated H pylori infection in 64 patients (27.95%). In contrast, 103 patients (69.59%) were H pylori negative after the 7-d therapy (P < 0.01). CONCLUSION: This pilot study suggests there is no beneficial effect of the one-day therapy in treatment of H pylori infection compared with the 7-d standard therapy.  相似文献   

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