CAJ | 학술논문

目的研究首次根除幽门螺杆菌（ Hp ）失败后二线药物的疗效，提高 Hp 最终根除率。方法选择我院消化科门诊经胃镜确诊慢性胃炎、消化性溃疡、胃癌等常见上消化道疾病Hp阳性患者，经首次根除Hp失败后病例750例作为研究对象，并随机分为A、B、C三组各250例。 A组250例，首先以PPI标准剂量＋果胶铋300 mg＋左氧氟沙星200 mg＋四环素500 mg，bid，治疗7 d；之后再以PPI标准剂量＋果胶铋300 mg＋阿奇霉素250 mg＋呋喃唑酮100 mg，bid，治疗7 d。 B组250例，PPI标准剂量＋果胶铋300 mg＋阿奇霉素250 mg＋呋喃唑酮100 mg，bid，疗程14 d。 C组250例，PPI标准剂量＋果胶铋300 mg＋左氧氟沙星200 mg＋四环素500 mg，bid，疗程14 d。结果 A、B、C三组Hp根除率分别为99.0％、86.0％、94.0％。 A组大于B组和C组。结论对于首次根除Hp失败患者，采取PPI＋果胶铋＋左氧氟沙星（或阿奇霉素）＋四环素（或呋喃唑酮）四联14 d疗法有较高的根除率，尤其是A组14 d序贯疗法根除Hp疗效更佳，三组均有用药简单，价格低廉，副作用少，患者依从性好，易于接受等特点。
목적연구수차근제유문라간균（ Hp ）실패후이선약물적료효，제고 Hp 최종근제솔。방법선택아원소화과문진경위경학진만성위염、소화성궤양、위암등상견상소화도질병Hp양성환자，경수차근제Hp실패후병례750례작위연구대상，병수궤분위A、B、C삼조각250례。 A조250례，수선이PPI표준제량＋과효필300 mg＋좌양불사성200 mg＋사배소500 mg，bid，치료7 d；지후재이PPI표준제량＋과효필300 mg＋아기매소250 mg＋부남서동100 mg，bid，치료7 d。 B조250례，PPI표준제량＋과효필300 mg＋아기매소250 mg＋부남서동100 mg，bid，료정14 d。 C조250례，PPI표준제량＋과효필300 mg＋좌양불사성200 mg＋사배소500 mg，bid，료정14 d。결과 A、B、C삼조Hp근제솔분별위99.0％、86.0％、94.0％。 A조대우B조화C조。결론대우수차근제Hp실패환자，채취PPI＋과효필＋좌양불사성（혹아기매소）＋사배소（혹부남서동）사련14 d요법유교고적근제솔，우기시A조14 d서관요법근제Hp료효경가，삼조균유용약간단，개격저렴，부작용소，환자의종성호，역우접수등특점。
Objective To explore the efficacy of second-line treatment for Helicobacter Pylori( HP) positive patients after failure of first eradication therapy .Methods 750 participates were diagnosed with common upper gastrointestinal diseases ,such as chronic gastritis , peptic ulcer and gastric cancer by gastroscopy , with positive HP after failure of first eradication therapy .The patients were randomly divided into group A , B and C ( all n=250 ) . Group A were administrated with PPI standard dose +Bismuth Pectin 300 mg+Levofloxacin 200 mg+Tetracycline 500 mg,bid, for 7 days;and then with PPI standard dose +Bismuth Pectin 300 mg +Azithromycin 250 mg +Furazolidone 100 mg, bid, for 7 days.Group B were taken with PPI standard dose +Bismuth Pectin 300 mg +Azithromycin 250 mg+Furazolidone 100 mg,bid,for 14 days.Group C were oralled with PPI standard dose +Bismuth Pectin 300 mg+Levofloxacin 200 mg+Tetracycline 500 mg,bid,for 14 days.Results The eradication rate of HP of Group A was 99.0%,Group B was 86.0%,Group C was 94.0%.Conclusions The quadruple therapy with PPI +Bismuth Pectin+Levofloxacin ( or Azithromycin ) +Tetracycline ( or Furazolidone ) , especially for 14 days in group A,had an obvious eradication rates for HP positive patients after failure of first eradication therapy .All of the three treatments had more simple medication ,lower price ,less side effect and better compliance .