短程三联疗法根除幽门螺杆菌的多中心临床研究

近年幽门螺杆菌（Ｈ．ｐｙｌｏｒｉ）菌株的耐药性总是日益突出，寻找有效且无耐药性的抗生素及联合治疗方案是当前十分重要的课题。本文旨在评价以奥美拉唑（Ｏ，２０ ｍｇ）或胶体次枸橼酸铋（Ｂ，２４０ ｍｇ）为基础的含呋喃唑酮（Ｆ，１００ ｍｇ）或甲唑（Ｍ，４００ ｍｇ）同时加用羟氨苄青霉素（Ａ，１ ０００ ｍｇ）或克拉霉素（Ｃ，２５０ ｍｇ）的４种短程（１周）三联疗法的Ｈ．ｐｙｌｏｒｉ根除率。方法：采用由

A Multicenter Clinical Study on Eradication of Helicobacter pylori Using Four Regimens of One-week Triple Therapy in China

Background/Aims: Short-term therapies for eradication of Helicobacter Pylori (H. pylori) have been reported worldwide with varying results. The purpose of this study was to evaluate the efficacy of one-week regimens containing three medications: omeprazole (O) or colloidal bismuth subcitrate (B),furazolidone (F) or metronidazole (M), and amoxicillin (A) or clarithromycin (C) at eradicating H. Pylori in a multicenter study involving 20 hospitals in China. Methods: 892 patients with non-ulcer dyspepsia (NUD) or healed duodenal ulcer (DU) disease confirmed by endoscopy were randomized to receive OMC, OFC, OFA, or BFC, twice daily for 7 days. 13C-urea breath test was performed 4~8 weeks after completion of treatment. Results: By protocol analysis, the eradication rate in patients receiving OMC was 65.9%, OFC 69.2%, OFA 86.6%, and BFC 80.4%. In patients with DU, the eradication rate of H. Pylori by OFA was higher than that in NUD (90.2% vs 83.5%, P<0.05). The adverse effects of the four regimens were mild, and mainly gastrointestinal. Conclusions: The efficacy of OMC was relatively low in this study. We suspect that this is the result of rising resistance of H. pylori to metronidazole and clarithromycin. The highest eradication rate is by OFA. We propose OFA to be the preferred regimen in areas where metronidazole and clarithromycin resistances are increasing.