含克拉霉素缓释片铋剂四联疗法初次根除幽门螺旋杆菌的临床疗效

目的 探讨克拉霉素缓释片初次根除幽门螺旋杆菌的临床疗效。方法 回顾性分析2019年1月至2020年12月间医院门诊收治的幽门螺旋杆菌初次根除患者资料,按克拉霉素剂型选择及用量不同分为三组,即克拉霉素片 500mg bid治疗组(A组)、克拉霉素缓释片 500mg bid治疗组(B组)和克拉霉素缓释片 500mg qd治疗组(C组)。各组治疗结束至少4周后,电话随访并比较分析不同治疗方案根除的有效率、依从性、不良反应发生率及成本-效果比。结果 剔除失访后,共350例纳入本研究,其中A组132例,B组101例,C组117例,各组总体根除率分别为95.45%、92.08%、97.44%。剔除低依从性患者6例(A组3例,B组3例,C组0例),根除率分别为95.35%、92.86%、97.44%。各组间根除率、依从性及不良反应发生率均无显著性差异(P＞0.05),但C组成本-效果比最低。以A组为参照,C组增量成本-效果比为-156.459。结论 克拉霉素缓释片可安全有效用于幽门螺旋杆菌感染患者的初次根除治疗,治疗时可按说明书推荐用量使用。

Efficacy of Quadruple Regimen Including Clarithromycin Sustained-Release Tablets for Primary Eradication of Helicobacter Pylori

ABSTRACT: OBJECTIVE To explore the clinical efficacy of clarithromycin sustained-release tablets in the primary eradication of Helicobacter pylori. METHODS Retrospective analysis of the data of patients with primary eradication of Helicobacter pylori admitted to the outpatient department of the hospital from January 2019 to December 2020 was conducted. They were divided into three groups according to the choice of clarithromycin dosage form and dosage, namely, clarithromycin tablets 500mg twice a day treatment group (Group A), clarithromycin sustained-release tablets 500mg twice a day treatment group (Group B), and clarithromycin sustained-release tablets 500mg once a day treatment group (Group C). At least 4 weeks after the end of treatment in each group, telephone follow-up was conducted to compare and analyze the efficacy, compliance, incidence of adverse reactions, and cost effectiveness ratio of different treatment schemes for eradication. RESULTS After eliminating lost visits, a total of 350 cases were included in this study, including 132 cases in Group A, 101 cases in Group B, and 117 cases in Group C. The overall eradication rates in each group were 95.45%, 92.08%, and 97.44%, respectively. Six patients with low compliance were excluded (3 in Group A, 3 in Group B, and 0 in Group C), with eradication rates of 95.35%, 92.86%, and 97.44%, respectively. There was no significant difference in the eradication rate, compliance, and incidence of adverse reactions among the groups (P>0.05), but the cost effectiveness ratio in Group C was the lowest. Taking Group A as a reference, the incremental cost effectiveness ratio for Group C was -156.459. CONCLUSION Clarithromycin sustained-release tablets can be safely and effectively used in the Primary eradication treatment of patients with Helicobacter pylori infection, and can be used according to the recommended dosage in the instructions.