两种短程小剂量三联疗法根除幽门螺杆菌的比较

目的比较两组短程小剂量三联方案(OTA奥美拉唑+替硝唑+阿莫西林;FFA法莫替丁+呋喃唑酮+阿莫西林)根除幽门螺杆菌感染的疗效.方法采用随机对照临床试验设计,经内镜检查、快速尿素酶试验和病理检查(MB染色)证实有Hp感染的患者132例.通过随机化方法分为2组,A组用OTA方案,B组用FFA方案,均治疗1周,随访6周.随访结束时行14C尿素呼气试验确定Hp根除情况.结果131例患者完成治疗及随访,两组的Hp根除率分别为84.8%和73.8%(P＞0.05).两组中胃炎患者的Hp根除率分别为89.2%和70.2%(P＜0.05),两组中溃疡患者的Hp根除率分别为79.3%和78.6%(P＞0.05).副作用发生率分别为15.2%、26.2%(P＞0.05),未发现严重副作用,所有患者均能耐受.A组药物费用明显高于B组(331.98元比77.26元).结论对Hp阳性的胃炎患者,应选价格较贵,但根除率高、副作用少的OTA方案;对Hp阳性的溃疡患者,可选价格低廉、疗效与OTA方案相当的FFA方案.

Comparison of two low-dose and short-duration triple therapies for treatment of helicobacter pylori infection

Aim To study the efficiency of two kinds of low-dose and short-duration triple therapies:omeprazole,tinidazole and amoxicillin (OTA) vs famotidine,furazolidone and amoxicillin(FFA),for helicobacter pylori (Hp) eradication.Methods One hurdred thirty-two patients with Hp infection confirmed by endoscopy,rapid urease test and pathology,were randomly allocated into two groups:group A (OTA) and group B(FFA).Patients received either therapy had been followed up for six weeks. 14C urea breath test were used to test the eradication rate.Results One hundred and thirty one patients completed all the study.The eradication rate was 84.8% in group A vs 73.7% in group B(P>0.05).The eradication rate of gastritis patients between the two groups were 89.2% vs 70.2%(P<0.05),The eradication rate of ulcer patients between the two groups were 79.3% vs 78.6%(P>0.05).More side effects occurred in group B than in group A but no difference between them (15.2% vs 26.2%,P>0.05),which were not serious and could be tolerated.The cost in group A is higher than that in group B(RMB 331.98 vs 77.26).Conclusion Considering the effectiveness and cost,OTA therapy was more suitable for gastritis patients.For ulcer patients,FFA therapy was as effective as the OTA therapy.