中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2014年
5期
24-26
,共3页
张亚辉%欧阳义%张丽艳%吕致斌%胡丽
張亞輝%歐暘義%張麗豔%呂緻斌%鬍麗
장아휘%구양의%장려염%려치빈%호려
幽门螺杆菌%序贯疗法%补救治疗%根除率
幽門螺桿菌%序貫療法%補救治療%根除率
유문라간균%서관요법%보구치료%근제솔
Helicobacter pylori%Sequential therapy%Rescue therapy%Eradication rate
目的：评价由雷贝拉唑、果胶铋、阿莫西林克拉维酸钾、左氧氟沙星、奥硝唑组成的10 d序贯疗法与10 d标准四联疗法对幽门螺杆菌（Hp）初治失败患者补救治疗的疗效及安全性。方法选取2012年4月至2014年2月永州市中心医院收治的Hp初次根除失败患者136例，随机均分为治疗组和对照组。治疗组前5 d予雷贝拉唑20 mg、果胶铋300 mg、阿莫西林克拉维酸钾1142.5 mg，口服2次/d，后5 d予雷贝拉唑20 mg、果胶铋300 mg、左氧氟沙星200 mg、奥硝唑500 mg，口服2次/d。对照组予雷贝拉唑20 mg、果胶铋300 mg、阿莫西林克拉维酸钾1142.5 mg、奥硝唑500 mg，口服2次/d，疗程10 d。观察药物不良反应发生率，停药治疗4周后行14 C呼气试验测定Hp。结果治疗组ITT根除率（91.18%）、PP根除率（93.94%）均较对照组（分别为79.41%和83.08%）高，差异有统计学意义（P<0.05）。治疗组药物不良反应发生率（4.45%）较对照组（10.77%）稍低，差异无统计学意义（P>0.05）。结论由雷贝拉唑、果胶铋、阿莫西林克拉维酸钾、左氧氟沙星、奥硝唑组成的10 d序贯疗法是一种Hp初治失败后安全而有效的补救治疗方案。
目的：評價由雷貝拉唑、果膠鉍、阿莫西林剋拉維痠鉀、左氧氟沙星、奧硝唑組成的10 d序貫療法與10 d標準四聯療法對幽門螺桿菌（Hp）初治失敗患者補救治療的療效及安全性。方法選取2012年4月至2014年2月永州市中心醫院收治的Hp初次根除失敗患者136例，隨機均分為治療組和對照組。治療組前5 d予雷貝拉唑20 mg、果膠鉍300 mg、阿莫西林剋拉維痠鉀1142.5 mg，口服2次/d，後5 d予雷貝拉唑20 mg、果膠鉍300 mg、左氧氟沙星200 mg、奧硝唑500 mg，口服2次/d。對照組予雷貝拉唑20 mg、果膠鉍300 mg、阿莫西林剋拉維痠鉀1142.5 mg、奧硝唑500 mg，口服2次/d，療程10 d。觀察藥物不良反應髮生率，停藥治療4週後行14 C呼氣試驗測定Hp。結果治療組ITT根除率（91.18%）、PP根除率（93.94%）均較對照組（分彆為79.41%和83.08%）高，差異有統計學意義（P<0.05）。治療組藥物不良反應髮生率（4.45%）較對照組（10.77%）稍低，差異無統計學意義（P>0.05）。結論由雷貝拉唑、果膠鉍、阿莫西林剋拉維痠鉀、左氧氟沙星、奧硝唑組成的10 d序貫療法是一種Hp初治失敗後安全而有效的補救治療方案。
목적：평개유뢰패랍서、과효필、아막서림극랍유산갑、좌양불사성、오초서조성적10 d서관요법여10 d표준사련요법대유문라간균（Hp）초치실패환자보구치료적료효급안전성。방법선취2012년4월지2014년2월영주시중심의원수치적Hp초차근제실패환자136례，수궤균분위치료조화대조조。치료조전5 d여뢰패랍서20 mg、과효필300 mg、아막서림극랍유산갑1142.5 mg，구복2차/d，후5 d여뢰패랍서20 mg、과효필300 mg、좌양불사성200 mg、오초서500 mg，구복2차/d。대조조여뢰패랍서20 mg、과효필300 mg、아막서림극랍유산갑1142.5 mg、오초서500 mg，구복2차/d，료정10 d。관찰약물불량반응발생솔，정약치료4주후행14 C호기시험측정Hp。결과치료조ITT근제솔（91.18%）、PP근제솔（93.94%）균교대조조（분별위79.41%화83.08%）고，차이유통계학의의（P<0.05）。치료조약물불량반응발생솔（4.45%）교대조조（10.77%）초저，차이무통계학의의（P>0.05）。결론유뢰패랍서、과효필、아막서림극랍유산갑、좌양불사성、오초서조성적10 d서관요법시일충Hp초치실패후안전이유효적보구치료방안。
Objective To evaluate the curative effect and security between 10-day sequential therapy including rabeprazole, colloidal Bismuth Pectin, amoxicillin and clavulanate potassium, levofloxacin and ornidazole and 10-day standard quadruple therapy for patients who fail on first-line Helicobacter pylori( H.pylori) eradication. Methods 136 Hp-positive patients with treatment failure of initial eradication were randomly divided into treatment group which included 68 patients and control group which included 68 patients.The treatment group was treated with rabeprazole 20 mg,colloidal Bismuth Pectin 300mg and amoxicillin and clavulanate potassium 1142.5 mg at first five days,orally two times a day at first five days and rabeprazole 20 mg,colloidal Bismuth Pectin 300 mg,levofloxacin 200 mg,and ornidazole 500 mg, orally two times a day at the second five days. The control group was treated with rabeprazole 20 mg, colloidal Bismuth Pectin 300 mg,amoxicillin and clavulanate potassium 1142.5mg and ornidazole 500mg, orally two times a day for ten days. The incidence of drug-related adverse reaction was observed during the medication and H.pylori was detected by 14C-urea breath test 4 weeks after discontinuation. Results The intention-to-treat eradication rate and Per protocol eradication rate in treatment group were higher than that in control group(91.18%, 93.94%vs 79.41%,83.08%),and the difference between two groups was statistically significant(P<0.05). The incidence of drug-related adverse reaction in treatment group was lower than that in control group(4.45%vs 10.77%),but the difference between two groups was not statistically significant(P>0.05). Conclusion The 10-day sequential therapy including rabeprazole, colloidal Bismuth Pectin, amoxicillin and clavulanate potassium, levofloxacin and ornidazole is an very safe and effective rescue therapy for Helicobacter pylori infection after initial treatment failure.
