餐后序贯与非序贯标准三联疗法根除幽门螺杆菌的疗效观察

目的：比较餐后序贯疗法与非序贯标准三联疗法根除幽门螺杆菌（Hp）的优效性。方法：将入选病例随机分为两组。治疗组（餐后序贯组）：埃索美拉唑40mg＋阿莫西林胶囊1．0g（饭后立即口服）＋克拉霉素胶囊0．5g（饭后2h服用），每日2次，疗程10d；对照组（非餐后序贯组）：埃索美拉唑40mg＋阿莫西林胶囊1．0g（饭后立即服用）＋克拉霉素胶囊0．5g（饭后立即服用），每日2次，疗程10d。收集非餐后序贯组治疗失败的病例，间歇30d后，再次给予餐后序贯疗法。结果：对比两组意向分析（ITT）的根除率分别为88．8％和77．1％（P〈0．05），餐后序贯组和非餐后序贯组方案分析（PP）根除率分别为95．4％和82．1％（P〈0．05），非餐后序贯组治疗失败病例再次给予餐后序贯疗法的Hp总根除率为56．0％。结论：餐后序贯标准三联疗法根除Hp的疗效好于非餐后序贯疗法。

The observation of post-meal sequential triple therapy for eradicating Hp infection comparing with non-sequential therapy

Objective：To compare the effectiveness of post-meal sequential therapy for eradicating Hp infection with non-sequential therapy. Methods：Patients were randomized into two groups：treatment group （post-meal sequential group） was treated with esomeprazole 40 mg bid × 10 d ,amoxicillin 1.0 g bid × 10 d immediately after meals ,clarithromycin 0.5 g bid × 10d till two hours after meal ,and the control group（non-sequential therapy group） was treated with esomeprazole 40 mg bid × 10 d,amoxicillin 1.0 g bid × 10 d immediately together with clarithromycin 0. 5 g bid after meals. Collected the failure cases with non-sequential therapy ,and started post-meal sequential therapy once again after 30 days. Results：The analysis was by intention-to-treat （ITT） and per protocol （PP）. The eradication rates of Hp by ITT were 88.8% with post-meal sequential group and 77.1% with non-sequential group（P〈0.05） respectively. The eradication rates of Hp by PP were 95.4% with post-meal sequential group and 82.1% with non-sequen- tial group（P〈0.05） respectively. Total eradication rates of Hp with post-sequential therapy in failure cases ,once again,was 56.0 %. Conclusion ：Post-meal sequential therapy for the eradication rate of Hp is better than non-sequential therapy.