CAJ | 학술논문

目的：对4种根除幽门螺杆菌感染的治疗方案进行疗效评价，探索根除幽门螺杆菌感染治疗的新途径。方法：选择2014年在本院就诊的经13C-尿素呼气试验（13C-UBT）或经胃黏膜活检快速尿素酶试验（RUT）及电子胃镜检查确诊为幽门螺杆菌感染的消化道溃疡患者240例，依病例入选先后次序按随机数字表法随机分为A、B、C、D 4组，每组60例，A组给予雷贝拉唑＋阿莫西林＋克拉霉素；B组给予雷贝拉唑＋阿莫西林＋左氧氟沙星；C组给予雷贝拉唑＋枸橼酸铋钾＋阿莫西林＋呋喃唑酮；D组给予给予雷贝拉唑＋阿莫西林＋克拉霉素＋双歧杆菌三联活菌肠溶胶囊；疗程均为14 d。比较4种治疗方案对幽门螺杆菌根除率的影响。结果：A、B、C、D 4组幽门螺杆菌根除率分别为73.3%，76.7%，93.3%，90.0%，A、B 2组疗效比较无统计学差异（P＞0.05），C、D 2组疗效比较无统计学差异（P＞0.05），但A、B 2组与C、D 2组疗效比较有统计学差异（P＜0.05）。结论：传统的三联疗法以及含左氧氟沙星的三联疗法幽门螺杆菌根除率不理想，加用标准剂量的铋制剂、微生态制剂可显著提高幽门螺杆菌根除率，是治疗幽门螺杆菌感染的新途径。
목적：대4충근제유문라간균감염적치료방안진행료효평개，탐색근제유문라간균감염치료적신도경。방법：선택2014년재본원취진적경13C-뇨소호기시험（13C-UBT）혹경위점막활검쾌속뇨소매시험（RUT）급전자위경검사학진위유문라간균감염적소화도궤양환자240례，의병례입선선후차서안수궤수자표법수궤분위A、B、C、D 4조，매조60례，A조급여뢰패랍서＋아막서림＋극랍매소；B조급여뢰패랍서＋아막서림＋좌양불사성；C조급여뢰패랍서＋구연산필갑＋아막서림＋부남서동；D조급여급여뢰패랍서＋아막서림＋극랍매소＋쌍기간균삼련활균장용효낭；료정균위14 d。비교4충치료방안대유문라간균근제솔적영향。결과：A、B、C、D 4조유문라간균근제솔분별위73.3%，76.7%，93.3%，90.0%，A、B 2조료효비교무통계학차이（P＞0.05），C、D 2조료효비교무통계학차이（P＞0.05），단A、B 2조여C、D 2조료효비교유통계학차이（P＜0.05）。결론：전통적삼련요법이급함좌양불사성적삼련요법유문라간균근제솔불이상，가용표준제량적필제제、미생태제제가현저제고유문라간균근제솔，시치료유문라간균감염적신도경。
ABSTRACTObjective:To evaluate the curative effects of 4 kinds of eradication therapy ofHelicobacterpylori (Hp)infection and explore the new way of eradication therapy of Hp infection.Methods:About 240 patients with peptic ulcer caused by Hp infection, who were diagnosed by13C - urea breath test(13C - UBT)or rapid urease test of gastric mucosa biopsy(RUT)and electronic gastroscopy in our hospital in 2014, were selected according to se-quence table and randomly divided into A, B, C and D groups, 60 cases in each group. Group A was given rabeprazole combined with amoxicillin and clarithromycin, group B was given rabeprazole combined with amoxi-cillin and levofloxacin, group C was treated with rabeprazole combined with bismuth potassium citrate, amoxicillin and furazolidone and group D was treated with rabeprazole combined with amoxicillin, clarithromycin and Bifid triple viable capsules dissolving at intestines, and the whole course of treatment was 14 days. To compare 4 kinds of therapy for Hp eradication rate.Results:The Hp eradication rates of 4 groups were 73.3%, 76.7%, 93.3% and 90.0%, the curative effects between groups A and B and between groups C and D had no significant differences (P>0.05), but there were significant differences in groups A, B and groups C, D(P<0.05).Conclusion:The Hp eradication rates of the conventional triple therapy and triple therapy with levofloxacin were not ideal, but the combined use with bismuth preparation and the standard dose of probiotics can significantly improve the Hp eradication rate. It may serve as a new way of treatment of Hp infection.