| 摘要: |
| 目的 比较含铋剂的四联疗法与序贯疗法对初次幽门螺杆菌（Hp）根治失败患者补救治疗的临床疗效。 方法将180 例于 2013 年 3 月至 2014 年 11 月根除 Hp 初治不成功者，按随机数字表法分成 3 组：序贯疗法组、四联疗法的 10d 疗程组和 14d 疗 程组，治疗结束 4 周后再复查 13C- 尿素呼气试验等，以了解 Hp根除效果，并比较其不适症状好转情况，不良反应及依从性。 结果 分别经按意向治疗和按方案分析，四联疗法的 14d 疗程组的 Hp根除率明显高于序贯疗法组（86.7%比 65.0%和 89.7% 比 75.0%，均 P＜0.05），而四联疗法 10d 疗程组根除率与序贯疗法组相比无统计学差异（71.7% 比 65.0%和 72.9%比 75.0%，均 P ＞0.05）；四联疗 法 14d 疗程组患者症状改善总有效率也显著高于序贯疗法及四联治疗方法 10d 疗程组（89.7% 比 71.2%和 89.7%比 76.3%，均 P＜0.05）；3 组患者的各种不良反应及依从性比较差异均无统计学意义。 结论 Hp根除不成功的患者，包括雷贝拉唑、多西环素、呋喃唑 酮及铋剂的四联治疗方案和序贯疗法方案都是一种有效的补救疗法，但与序贯疗法相比，疗程为 14d 的四联治疗方案对 Hp 的根除效 果更好。 |
| 关键词: 幽门螺杆菌 序贯疗法 四联疗法 补救治疗 |
| DOI： |
| 分类号: |
| 基金项目: |
|
| Rescue therapy for patients who failed to eradicate Helicobacter pylori : standard quadruple therapy versus sequential therapy |
|
XU Tiancai, LIN Hai, LIU Yuan, DONG Jiaojing, WAN Xiuping, Bian Jun, WENG Huibin
|
|
Quzhou People's Hospital
|
| Abstract: |
| Objective To evaluate the efficacy of standard quadruple therapy containing rabeprazole, doxycycline, furazolidone, bismuth and sequential therapy as rescue therapies for patients who failed to eradicate Helicobacter pylori(Hp). Methods One hundred and eighty patients who failed to eradicate Hp from 2013 March to 2014 November in Quzhou People's Hospital were randomly assigned into sequential therapy group, 10 day-quadruple therapy group and 14-day quadruple therapy group. Four weeks after the end of treatment, 13C-urea breath test was re-examined. The Hp eradication rate, clinical symptoms improvement, side effects and compliance were compared among three groups. Results Hp eradication rates according to intent-to-treat (ITT) and per-protocol (PP) analyses in 14-day quadruple therapy group were significantly higher than those in sequential therapy group (86.7% vs.65.0% and 89.7% vs. 75.0%, both P ＜0.05), but there was no difference between 10-day quadruple therapy group and sequential therapy group (71.7% vs. 65.0% and 72.9% vs. 75.0% , both P ＞0.05), The clinical symptoms improvement in 14-day quadruple therapy group were more markedly than that in sequential therapy group and 10-day quadruple therapy group (89.7% vs. 71.2% and 89.7% vs. 76.3%, both P ＜0.05); there were no significant differences in incidence of adverse reactions among three groups. Conclusion Both quadruple therapy and sequential therapy can be used as a rescue therapy for eradication of Hp in patients with failed Hp eradication; however, the efficacy of 14-day quadruple therapy is superior to sequential therapy. |
| Key words: H. pylori Quadruple therapy Sequential Therapy Rescue Therapy |
