电话随访对幽门螺杆菌感染患者服药依从性及根除率的影响

目的：探讨书面告知结合电话随访对幽门螺杆菌(H. pylori)感染患者服药依从性及疗效的影响。方法：采用随机对照试验设计，将160例14C-尿素呼气试验结果阳性的患者随机分为电话随访组(80例)和对照组(80例)，两组均发放书面告知——《幽门螺杆菌感染患者服药指导》，随访组患者在书面告知基础上实施电话随访。试验结束后分别评价两组患者的H. pylori根除率、服药依从性、不良反应发生率及H. pylori根除过程中患者心理接受程度有无差异。结果：采用符合方案集分析方法，电话随访组H. pylori根除率为64.4%，对照组为56.5%；采用意向性分析方法，随访组H. pylori根除率为58.8%，对照组为43.8%，两种分析方法两组比较差异均无统计学意义(P>0.05)。电话随访组患者服药依从性高于对照组(91.3% vs 77.5%，P<0.05)。电话随访组与对照组分别有11例和36例患者在H. pylori根除过程中出现了恶心、口腔异味、腹胀、纳差和大便习惯改变等不良反应，但电话随访组发生率明显低于对照组(13.7% vs 58%，P<0.05)。H. pylori根除过程中患者心理接受程度良好者电话随访组高于对照组(75.3% vs 51.6%，P<0.05)；接受程度一般者电话随访组低于对照组(19.2% vs 27.4%)，但差异无统计学意义(P>0.05)；接受程度较差者电话随访组低于对照组(5.5% vs 21.0%，P<0.05)。结论：电话随访对H. pylori根除率无影响，但可提高患者服药依从性，减轻患者服药过程中的不良反应，提高患者在服药过程中对药物治疗的接受程度。

Effect of telephone follow-up on compliance and Helicobacter#br#pylori eradication in patients with Helicobacter pylori infection

Objective: To evaluate effect of telephone follow-up combined with written instruction oncompliance and Helicobacter pylori (H. pylori) eradication in patients with H. pylori infection.Methods: A total of 160 H. pylori positive patients were randomly divided into an experimentalgroup and a control group (n=80 in each group). All the patients got the guide instruction named“the guidance of clinical medication for H. pylori infection patients” before the treatment. Thepatients in the experimental group were added individualized follow-up with telephone. Thecompliance, eradication of H. pylori, adverse events, and satisfaction were compared between the 2groups.Results: The eradication rate of H. pylori in the perprotocol analysis for the experimental groupand control group were 64.4% (47/73) and 56.5%(35/62), respectively (P=0.380), while in theintention-to-treat analysis, the rates were 58.8% (47/80) and 43.8% (35/80, P=0.082), respectively.The compliance rate in the experimental group was significantly higher than that in the controlgroup (91.3% vs 77.5%, P<0.05). There was significant difference in patients’ satisfaction in goodones (75.3% vs 51.6%) and poor ones (5.5% vs 21.0%) between the 2 groups (P<0.05). Therewere 11 patients in the experimental group and 36 patients in the control group, who appearedadverse reactions such as nausea, bad breath, abdominal distention, poor appetite, and defecationhabit change during the process of eradicating H. pylori, but the occurrence rate in the experimentalgroup was obviously lower than that in the control group (15.1% vs 58.1%, P<0.05).Conclusion: The telephone follow-up cannot increase the H. pylori eradication rate, but it canimprove compliance and satisfaction for the patients and relieve adverse effects.