三联疗法治疗幽门螺杆菌感染的临床观察

目的:观察三联疗法治疗幽门螺杆菌(Hp)感染的临床疗效和安全性。方法:将100例Hp感染患者随机均分为对照组和试验组。对照组患者给予奥美拉唑肠溶片20 mg,口服,每日1次+阿莫西林胶囊2粒,口服,每日2次+克拉霉素片1片,口服,每日2次;试验组患者给予奥美拉唑肠溶片(用法用量同对照组)+阿莫西林胶囊(用法用量同对照组)+左氧氟沙星片5片,口服,每日1次。两组患者疗程均为7 d。活动性溃疡者,在Hp根除治疗后继续服用奥美拉唑肠溶片20 mg,每日1次,连用4周。观察两组患者临床疗效,完成治疗Hp根除率及意向治疗Hp根除率,治疗前后临床症状总积分及病理积分及不良反应发生情况。结果:100例患者均完成治疗,13例患者失访,失访率为13.0%;其中试验组失访6例,对照组失访7例。试验组患者总有效率、完成治疗Hp根除率显著高于对照组,两组比较差异均有统计学意义(P<0.05);两组患者意向治疗Hp根除率、不良反应发生率比较,差异均无统计学意义(P>0.05);治疗后两组患者临床症状总积分和病理积分均显著低于同组治疗前,且试验组低于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:左氧氟沙星联合奥美拉唑、阿莫西林治疗Hp感染较克拉霉素联合奥美拉唑、阿莫西林疗效更显著,安全性相似。

Clinical Observation of Triple Therapy for Helicobacter pylori Infection

OBJECTIVE：To observe clinical efficacy and safety of triple therapy in the treatment of Helicobacter pylori（Hp）infection. METHODS：100 patients with Hp infection were randomly divided into trial group and control group. Control group was given Omeprazole enteric-coated tablet 20 mg orally once a day,two Amoxicillin capsules orally twice a day and one Clarithromycin tablet orally twice a day. Trial group was given Omeprazole enteric-coated tablet and Amoxicillin capsules（same usage and dosage as control group）,five Levofloxacin tablets orally once a day. Treatment course of 2 groups lasted for 7 days. The patients with active ulcer continuously received Omeprazole enteric-coated tablet 20 mg once a day for 4 weeks after Hp eradication treatment.Clinical efficacies of 2 groups were observed,and Hp eradication rate of complete therapy and intention to treat after treatment,total clinical symptom score and pathological score before and after treatment and the occurrence of ADR were also observed in 2groups. RESULTS：All the 100 patients had completed the treatment,and 13 patients were failure to follow up with failure rate of13.0%,involving 6 patients in trial group and 7 patients in control group. According to complete treatment,Total effective and Hp eradication rate of experimental group was significantly higher than that of control group,there was statistical significance between2 groups（P〈0.05）. According to intention to treat,Hp eradication rate and the incidence of ADR had no statistical significance between 2 groups（P〉0.05）;after treatment,above 2 indicators of 2 groups were significantly than before,and the trial group was lower than the control group;there was statistical significance（P〈0.05）. There was no statistical significance in the in cidence of ADR between 2 groups（P〉0.05）. CONCLUSIONS：Levofloxacin combined with omeprazole and amoxicillin is more effective and safer than clarithromycin combined with omeprazole and amoxicillin in the treatment of Hp infection.