序贯疗法与标准三联疗法治疗幽门螺杆菌相关性萎缩性胃炎的疗效对比

目的 比较序贯疗法与标准三联疗法治疗幽门螺杆菌（Hp）相关慢性萎缩性胃炎（CAG）的临床疗效.方法 120例Hp阳性CAG患者随机分为治疗组、对照组各60例,治疗组采用10 d序贯疗法治疗,前5d口服埃索美拉唑镁肠溶片＋阿莫西林胶囊,后5d改为埃索美拉唑镁肠溶片＋左氧氟沙星胶囊＋呋喃唑酮片.对照组按标准三联疗法用药：枸椽酸铋钾片＋替硝唑片＋克拉霉素片.两组疗程均为12周.观察患者症状改善情况、Hp清除及胃黏膜炎症改变情况.结果 治疗组总有效率为95.0％,显著高于对照组（80.0％）（P＜0.05）;治疗组Hp根除率和1年复发率为86.7％和15.4％,对照组分别为68.3％和36.6％,组间比较差异均有统计学意义（P＜0.05）;治疗后治疗组胃黏膜慢性炎症程度评分较治疗前及对照组明显改善（P＜0.05）.结论 序贯疗法对Hp相关性CAG患者Hp根除效果显著,可明显改善患者临床症状及胃黏膜炎症程度.

Comparison of sequential therapy and triple therapy on patients of atrophic gastritis with Helicobacter priori infection

Objective To compare the therapeutic effects of sequential therapy and triple therapy on patients of chronic atrophic gastritis（CAG） with Helicobacter pylori（Hp）infection.Methods 120 patients of atrophic gastritis with Hp infection were randomly divided into 2 groups. Treatment group （n=60） was treated with sequential therapy,which took esomeprazole and amoxicillin for the first 5 days, followed by esomeprazole,levofloxacin and furazolidone in the next 5 days. And control group （n=60） was treated with triple therapy,which took bismuth potassium citrate,tinidazole piece and clarithromycin. The two groups were treated for 12 weeks.To observe the improvement of symptoms, Hp eradication rates and chronic inflammation of gastric mucosa. Results The total effective rate in treatment group was 95.0%, which was significantly higher than 80.0% in control group （P〈0.05）. There was significant difference on Hp eradication rate and 1-year recurrence rate between treatment group and control group （86.7% vs 67.3%, 15.4%vs 36.6% ,P〈0.05）. After treatment, the chronic inflammation degree of gastric mucosa in treatment group was more remarkably than that before treatment and in control group （P〈0.05）. Conclusion The sequential therapy has a better Hp eradication effect for Hp positive CAG patients,and the therapy can greatly improve the clinical symptoms and gastric mucosal inflammation.