序贯疗法根除幽门螺杆菌的临床研究

目的:探讨埃索美拉唑镁、克拉霉素、左氧氟沙星与替硝唑10d序贯疗法根除幽门螺杆菌(Hp)的效果及不良反应。方法:将122例经胃镜检查确诊Hp阳性患者随机均分为试验组与对照组。试验组在前5d给予埃索美拉唑镁20mg+克拉霉素500mg,后5d给予埃索美拉唑镁20mg+左氧氟沙星200mg+替硝唑500mg;bid,共10d;对照组给予埃索美拉唑镁20mg+阿莫西林1000mg+呋喃唑酮100mg,bid,共14d。2组均于疗程结束后4周复查检测Hp。结果:试验组Hp根除率为88.1%,对照组为67.2%,2组比较有显著性差异(P<0.05)。试验组有5例(8.5%)、对照组有15例(25.9%)发生不良反应,2组比较有显著性差异(P<0.05)。结论:由埃索美拉唑镁+克拉霉素+左氧氟沙星+替硝唑组成的10d序贯疗法可以明显提高Hp根除率,试验组不良反应发生率较对照组低。

Study on Sequential Therapy for Helicobacter Pylori Eradication

OBJECTIVE：To investigate clinical efficacy of the treatment of Helicobacter pylori （Hp） with esomeprazole magnesium, clarithromycin, levofloxacin and tinidazole for 10 d sequential therapy and its side effect.METHODS：122 patients diagnosed Hp-positive with gastroscopy were randomly divided into experimental and control groups.For the experimental group, in the first 5 days, esomeprazole magnesium 20 mg and clarithromycin 500 mg were given; and in the next 5 days, esomeprazole magnesium 20 mg, levofloxacin 200 mg and tinidazole 500 mg were given.They were given twice a day for a total of 10 days.For the control group, esomeprazole magnesium 20 mg, amoxicillin 1 000 mg and furazolidone 100 mg were given twice a day for a total of 14 days.4 weeks after the treatment, Hp of 2 groups was detected again.RESULTS：The eradication rate was 88.1% in the experimental group and 67.2% in the control group; in the experimental group, the Hp eradication rate was significantly higher than that in the control group （P0.05）.About the incidence of side effects, there were 5 cases in the experimental group （8.5%） and15 cases in the control group （25.9%）; the latter was significantly higher than the former （P0.05）.CONCLUSION：The 10-day sequential therapy of esomeprazole magnesium, clarithromycin, tinidazole and levofloxacin can significantly improve the Hp eradication rate.The ADR of experimental group is lower.