克拉霉素为基础的三联方案根除幽门螺杆菌的疗效研究

克拉霉素是根除幽门螺杆菌（Hpylori）感染的有效药物，以克拉霉素为基础的三联方案根除Hpylori在临床上广泛应用。目的：评估克拉霉素为基础的三联方案根除日．pylori的疗效。方法：133例Hpylori感染患者随机分为3组，A组：埃索美拉唑20mgbid＋克拉霉素0．5gbid＋阿莫西林1gbid，疗程7d；B组：埃索美拉唑20mgbid＋克拉霉素0．5gbid＋左氧氟沙星0．5gqd，疗程7d；C组：埃索美拉唑20mgbid＋克拉霉素0．5gbid＋呋喃唑酮0．1gtid，疗程7d。治疗结束后4～8周复查”C-尿素呼气试验和快速尿素酶试验以评估根除疗效。结果：128例患者按方案完成治疗。A、B、C组按意向治疗（11-r）分析日．pylori根除率分别为84．4％、77．3％、75．0％，按方案（PP）分析分别为88．4％、79，1％、78．6％。A组的11Tr和PP根除率高于B组和C组，但差异无统计学意义（P〉0．05）。结论：克拉霉素联合质子泵抑制剂（PPI）和阿莫西林7d疗法仍为有效的Hpylori感染根除方案。

Therapeutic Effect of Clarithromycin-based Triple Therapy for Helicobacter pylori Eradication

Clarithromycin is effective for eradication of Helicobacter pylori （ H. pylori） infection. Clarithromycin- based triple therapy has been widely used in clinical practice. Aims： To assess the efficacy of clarithromycin-based triple therapy for H. pylori eradication. Methods： A total of 133 11. pylori-infected patients were enrolled and randomly assigned into three groups. Patients in group A were given esomeprazole 20 mg bid ＋ elarithromyein 0.5 g bid ＋ amoxicillin 1 g bid for 7 days. Patients in group B were given esomeprazole 20 mg bid ＋ clarithromycin 0.5 g bid ＋ levofloxacin 0.5 g qd for 7 days. Patients in group C were given esomeprazole 20 mg bid ＋ clarithromycin 0.5 g bid ＋ furazolidone 0.1 g tid for 7 days. At 4-8 weeks after a course of treatment, H. pylori eradication was assessed by 13 C-urea breath test and rapid urease test. Results： A total of 128 patients completed the study. H. pylori eradication rates by intention-to-treat （ITY） analysis in group A, B and C were 84.4%, 77.3% and 75.0% , respectively; by per-protocol （PP） analysis were 88.4% , 79.1% and 78.6% , respectively. The eradication rate in group A was higher than that in group B and C by both ITF and PP analysis, but no statistically significant differences were found among the three groups （ t9 〉 0.05 ）. Conclusions ： The proton pump inhibitor （PPI）-clarithromycin-amoxicillin 7-day triple therapy is still an effective treatment for eradication of H. pylori infection.