现代消化及介入诊疗
現代消化及介入診療
현대소화급개입진료
MODERN DIGESTION & INTERVENTION
2015年
3期
193-195
,共3页
徐海燕%谭克文%代高举%宋仁%刘锫%彭燕%陈奇%胡刚%罗敏%房殿春
徐海燕%譚剋文%代高舉%宋仁%劉锫%彭燕%陳奇%鬍剛%囉敏%房殿春
서해연%담극문%대고거%송인%류부%팽연%진기%호강%라민%방전춘
幽门螺杆菌%铋剂为基础的四联治疗%序贯治疗%补救
幽門螺桿菌%鉍劑為基礎的四聯治療%序貫治療%補救
유문라간균%필제위기출적사련치료%서관치료%보구
Helicobater pylori%Bismuth-based quadruple therapy%Sequential therapy%Rescue therapy
目的：评价两种幽门螺杆菌(Helicobacter pylori, H. pylori)补救治疗方案的的疗效和安全性。方法选择我院消化内科规范根除H. pylori,三联方案治疗失败病例163例,随机分为四联方案组(奥美拉唑20 mg+阿莫西林1.0 g+替硝唑500 mg+胶体果胶铋200 mg)和序贯方案组(先奥美拉唑20 mg+阿莫西林1.0 g,后奥美拉唑20 mg+痢特灵0.1 g+克拉霉素500 mg),治疗结束至少4周后通过13C-尿素呼吸试验判断根除效果,评价安全性。结果四联方案组78例,H. pylori根除69例,根除率88.5%,不良反应发生率为14.1%(11例)；序贯方案组85例,H. pylori根除70例,根除率82.3%,不良反应发生率为32.9%(28例),两组根除率比较无显著差异,但四联方案组不良反应发生率低于序贯方案组,且有统计学意义(P<0.05)。结论四联方案及序贯方案均能有效根除H. pylori,序贯方案不良反应发生率相对较高。
目的：評價兩種幽門螺桿菌(Helicobacter pylori, H. pylori)補救治療方案的的療效和安全性。方法選擇我院消化內科規範根除H. pylori,三聯方案治療失敗病例163例,隨機分為四聯方案組(奧美拉唑20 mg+阿莫西林1.0 g+替硝唑500 mg+膠體果膠鉍200 mg)和序貫方案組(先奧美拉唑20 mg+阿莫西林1.0 g,後奧美拉唑20 mg+痢特靈0.1 g+剋拉黴素500 mg),治療結束至少4週後通過13C-尿素呼吸試驗判斷根除效果,評價安全性。結果四聯方案組78例,H. pylori根除69例,根除率88.5%,不良反應髮生率為14.1%(11例)；序貫方案組85例,H. pylori根除70例,根除率82.3%,不良反應髮生率為32.9%(28例),兩組根除率比較無顯著差異,但四聯方案組不良反應髮生率低于序貫方案組,且有統計學意義(P<0.05)。結論四聯方案及序貫方案均能有效根除H. pylori,序貫方案不良反應髮生率相對較高。
목적：평개량충유문라간균(Helicobacter pylori, H. pylori)보구치료방안적적료효화안전성。방법선택아원소화내과규범근제H. pylori,삼련방안치료실패병례163례,수궤분위사련방안조(오미랍서20 mg+아막서림1.0 g+체초서500 mg+효체과효필200 mg)화서관방안조(선오미랍서20 mg+아막서림1.0 g,후오미랍서20 mg+리특령0.1 g+극랍매소500 mg),치료결속지소4주후통과13C-뇨소호흡시험판단근제효과,평개안전성。결과사련방안조78례,H. pylori근제69례,근제솔88.5%,불량반응발생솔위14.1%(11례)；서관방안조85례,H. pylori근제70례,근제솔82.3%,불량반응발생솔위32.9%(28례),량조근제솔비교무현저차이,단사련방안조불량반응발생솔저우서관방안조,차유통계학의의(P<0.05)。결론사련방안급서관방안균능유효근제H. pylori,서관방안불량반응발생솔상대교고。
Objective To compare the efficacy and safety of sequential and bismuth-based quadruple therapies as rescue therapy for H. pylori eradication. Methods One hundred and sixty-three patients, in whom the initial standard triple therapy had failed to eradicate H. pylori infection were included in this study. Patients were randomly assigned to two groups to receive either 10-day sequential therapy or 14-day bismuth-based quadruple therapy with omeprazole (20 mg Bid)), plus colloidal bismuth pectin capsules (200 mg bid), amoxi-cillin (1,000 mg bid), and tinidazole (500 mg bid), respectively. The eradication effect was assessed by the 13C-urea breath test 4 weeks after treatment, adverse events were recorded. Results The eradication rates of H. py-lori in bismuth-based quadruple therapy group and sequential therapy group were 88.5%and 82.3%, respec-tively (P>0.05). The rates of adverse events were 14.1%and 32.9%, respectively. The rate of adverse events in sequential therapy group was statistically significantly higher than that in bismuth-based quadruple therapy group (P<0.05). Conclusion Both bismuth-based quadruple therapy and the sequential therapy were effec-tive as rescue regimen for H. pylori eradication after failure of standard triple treatment. However, sequential therapy showed a higher rate of adverse effects.
