三联疗法根除幽门螺杆菌临床观察

目的：探讨枸橼酸铋雷尼替丁加左氧氟沙星加呋喃唑酮三联1周疗法根除幽门螺杆菌的疗效及安全性。方法：选择110例符合条件的幽门螺杆菌阳性慢性胃炎和消化性溃疡患者，随机分为两组。治疗组采用枸橼酸铋雷尼替丁（350mg，2次／d）加左氧氟沙星（200mg，2次／d）加呋喃唑酮（100mg，2次／d），治疗7d；溃疡患者继用枸橼酸铋雷尼替丁350mg，2次／d，3周。对照组采用奥美拉唑（20mg，2次／d）加阿莫西林（1．0g，2次／d）加甲硝唑（400mg，2次／d），治疗7d；溃疡患者继用奥美拉唑20mg，1次／d，3周。疗程结束后4周及8周复查Hp，观察幽门螺杆菌根除率、症状缓解率、溃疡愈合率及不良反应等。结果：治疗组和对照组的症状缓解率、幽门螺杆菌根除率、溃疡治愈率、不良反应发生率分别为91．8％、81．6％、90，5％、32．7％和94．0％、86．0％、95．0％、28．0％，差异无统计学意义（P〉0．05）。治疗组与对照组每例根除幽门螺杆菌费用分别为100．10元、274．68元，治疗组根除幽门螺杆菌期望成本比对照组低196．77元。结论：幽门螺杆菌加左氧氟沙星加呋喃唑酮三联1周疗法是根除幽门螺杆菌的理想方案，可作为根除幽门螺杆菌一线治疗的选择。

Clinical study on ranitidine bismuth citrate, ilevofloxacin and furazolidone combination therapy for helicobacter pylori eradication

Objective To study the effect and safety of oneweek combination therapy of ranitidine bismuth citrate,ilevofloxacin and furazolidone in the eradication of helicobacter pylori.Methods One hundred and ten cases of helicobacter pylori infection suffering from chronic gastritis and peptic ulcer were randomly divided into treatment group and control group.The treatment group received ranitidine bismuth citrate(350 mg,twice a day),ilevofloxacin(200 mg,twice a day) and furazolidone(100 mg,twice a day) for 1 week,while control group received omeprazole(20 mg,twice a day),amoxicillin(1.0 g,twice a day) and metronidazole(400 mg,twice a day) for 1 week.The patients with peptic ulcer were treated with ranitidine bismuth citrate(350 mg,twice a day) or omeprazole(20 mg,once a day) for another three weeks.Four and eight weeks later,the helicobacter pylori eradication,symptoms,peptic ulcer healing and adverse effect were observed.Results The helicobacter pylori eradication rate,symptom ameliorate rate,peptic ulcer healing rate and adverse effect rate between the treatment group and control group were 91.8% and 94.0%,81.6% and(86.0%),90.5% and 95.0%,32.7% and 28.0%,respectively.There was no statistic difference(P>(0.05)).The cost of anti-helicobacter pylori therapy of each patient was 100.10 Yuan(RMB) and(274.68) Yuan(RMB) in the treatment group and control group respectively.Conclusion One week combination therapy of ranitidine bismuth citrate,ilevofoxacin and furazolidone is the first choice for helicobacter pylori eradication.