两种常用根除幽门螺杆菌三联方案的疗效观察

目的：观察两种常用一线根除幽门螺杆菌（H.pylori）三联方案在本地区（成都市）的疗效。方法：纳入70例诊断为消化性溃疡、慢性糜烂性胃炎、慢性萎缩性胃炎伴H.pylori感染的患者。随机分为A、B两组。A组采用埃索美拉唑（E）20 mg bid＋克拉霉素（C）500 mg bid＋甲硝唑（M）400 mg bid,B组采用E 20 mg bid＋C 500 mg bid＋阿莫西林（A）1.0g bid治疗,疗程7天。H.pylori根除失败者以1周四联方案：E 20 mg bid＋胶体次枸櫞酸铋（B）220 mg bid＋呋喃唑酮100 mg bid＋A1.0g bid治疗,观察疗效。结果：64例完成实验。三联方案H.pylori根除率：A组62.5%,B组84.4%,有显著差异（P〈0.05）。二线四联方案根除率94.1%。结论：ECA方案H.pylori根除率明显高于ECM方案,可能更适合于本地区根除H.pylori的一线治疗,EBFA方案作为二线治疗具有较高疗效。

Comparison of Effect of Two Common First-line Triple Therapies on Helicobacter Pylori Infection

Objective： To observe the effect of two common first-line triple therapy on H elicobacter pylori（H, pylori） Infection. Methods： Seventy patients diagnosed as peptic ulcer, chronic erosive gastritis and chronic atrophic gastritis with of H. pylori were included and randomly divided into two groups. A group was administered with esomeprazole（E） 20rag bid, clarithromycin（C） 500rag bid and metronidazole（M） 400rag bid,B group received E and C combined with amoxicillin（A）1. 0g bid. The treatment duration was 7 days. The patients with H. pylori unsuccessful eradication were administered with E 20mg bid, colloidal bismuth subcitrate（B） 220mg bid, Furanzolidone（F） 100mg hid and A 1.0g bid for 7days. Results：Sixty-four patients completed the study. The H. pylori eradication rates of triple therapy： A group was 62.5% ,B group was 84.4%. The difference was significant （P〈0.05）. The H. pylori eradication rate of the quadruple therapy was 94.1%. Conclusion： The H. pylori eradication rate of ECA triple therapy is significantly higher than the ECM regimen. It may be better to choose the former as the first-line therapy in Chengdu. The quadruple therapy EBFA is effective for the second-line of H. pylori eradication.