含莫西沙星三联疗法与传统三联疗法对老年患者幽门螺杆菌感染的疗效比较

目的 观察含莫西沙星三联疗法治疗幽门螺旋杆菌（Helicobacter pylori,Hp）的效果.方法 选择经14C尿素呼气试验（14C-UBT）确诊的120例Hp感染的老年患者,随机分成试验组和对照组两组,每组60例.试验组患者给予含莫西沙星三联疗法,即同时口服莫西沙星（400mg,1次/d）、雷贝拉唑（10 mg,2次/d）和阿莫西林（1g,2次/d）;对照组患者给予传统三联疗法,即同时口服克拉霉素（500 mg,2次/d）、雷贝拉唑（10 mg,2次/d）和阿莫西林（1g,2次/d）.观察分两个阶段：（1）治疗2w,停药4w后复查^14C-UBT,（2）接着对两组耐药患者进行互换疗法治疗2w,停药4w后再次复查^14C-UBT;比较两组的治愈率和耐药率的差异.结果 与对照组比较,试验组治愈率明显升高,耐药率显著降低（皆P＜0.01）.对两组中出现耐药的患者进行交换疗法治疗,试验组中出现耐药的患者11例,换用传统三联疗法几乎无效;而对照组中出现耐药患者28例,换用含莫西沙星三联疗法后,治愈率升高和耐药率降低（皆P＜0.01）.结论 含莫西沙星三联疗法对老年患者幽门螺杆菌感染的治愈率高和耐药率低,值得在临床上推广应用.

Copmpared effects between triple therapy including moxifloxacin and traditional triple therapy on Helicobacter pylori infection in the elderly patients

Objective To study the effect of triple therapy including moxifloxacin on Helicobacter pylori in the elderly patients. Methods 120 cases of H. pylori infection diagnosed by ^14C-UBT were randomly divided into two groups： experimental group and control group, 60 cases each group. The experimental group were treated with the triple therapy including moxifloxacin （moxifloxacin 400 mg qd, rabeprazole 10 mg bid, amoxiciUin 1 g bid）, while the contrl group were treated with the traditional triple therapy （clarithromycin 500 mg Bid, rabeprazole 10 nag bid, amoxicillin 1 g bid） for 2 weeks, respectively. The cure rates and drug resistance rates of the two groups were assessed and compared. Then, the cases with drug resistance in the experimental group were treated with the traditional triple therapy, while the cases with drug resistance in the control group accepted the triple therapy including moxifloxacin. After 2 weeks of exchanged treatment, the cure rates and resistance rates of the two groups were assessed and compared. Results Compared with the control group, the cure rates were significantly higher and the resistance rates were lower in the experimental group （P〈0.01）. 11 cases with drug resistance in the experimental group, which were treated with the traditional triple therapy, had no effect. Whereas 28 drug resistant cases had good effect in the control group after the exchanged treatment with the triple therapy including moxifloxacin （P 〈 0.01 ）. Conclusion Treatment of the triple therapy including moxifloxacin for Helicobacter pylori increases cure rate and decrease drug resistance, which is worthy of clinical application.