中国医学创新
中國醫學創新
중국의학창신
Medical Innovation of China
2015年
29期
69-72,73
,共5页
幽门螺杆菌%序贯疗法%标准三联疗法%雷贝拉唑%奥美拉唑
幽門螺桿菌%序貫療法%標準三聯療法%雷貝拉唑%奧美拉唑
유문라간균%서관요법%표준삼련요법%뢰패랍서%오미랍서
Helicobacter pylori%Sequential therapy%Standard triple therapy%Rabeprazole%Omeprazole
目的：比较以雷贝拉唑、阿莫西林、克拉霉素、呋喃唑酮组成的10 d序贯疗法与奥美拉唑+阿莫西林+呋喃唑酮组成的10 d标准三联疗法根除幽门螺杆菌（Hp）的疗效和安全性。方法：160例Hp感染活动性消化性溃疡患者随机分为治疗组和对照组，每组80例。治疗组为序贯疗法组：给予雷贝拉唑10 mg/次、阿莫西林1000 mg/次，2次/d，服用5 d，5 d后口服雷贝拉唑10 mg/次、克拉霉素500 mg/次、呋喃唑酮100 mg/次，2次/d，再服用5 d，10 d后使用雷贝拉唑10 mg/次，1次/d，续服3周。对照组为标准三联疗法组：第1~10天给予奥美拉唑20 mg/次、阿莫西林1000 mg/次、呋喃唑酮100 mg/次，2次/d，第11~31天服用奥美拉唑20 mg/次，1次/d。治疗结束后4周复查胃镜，行快速尿素酶试验和14C尿素呼气试验测定Hp，评估疗效及安全性。结果：156例患者按方案完成治疗。治疗组按ITT分析Hp根除率为92.50%（74/80），明显高于对照组的78.75%（63/80），差异有统计学意义（字2=19.262，P<0.01）。治疗组按PP分析Hp根除率为94.87%（74/78），明显高于对照组的80.77%（63/78），差异有统计学意义（字2=15.566，P<0.01）。治疗组和对照组的不良反应发生率分别为18.75%（15/80）和22.50%（18/80），比较差异无统计学意义（P>0.05）。结论：雷贝拉唑、阿莫西林、呋喃唑酮、克拉霉素组成的10 d序贯治疗方案较奥美拉唑、阿莫西林、呋喃唑酮组成的标准三联10 d治疗方案更加能有效根除Hp，取得了很高的Hp根除率，治疗效果佳，个体差异小，不良反应发生率低，患者依从性好，值得临床上推广应用。
目的：比較以雷貝拉唑、阿莫西林、剋拉黴素、呋喃唑酮組成的10 d序貫療法與奧美拉唑+阿莫西林+呋喃唑酮組成的10 d標準三聯療法根除幽門螺桿菌（Hp）的療效和安全性。方法：160例Hp感染活動性消化性潰瘍患者隨機分為治療組和對照組，每組80例。治療組為序貫療法組：給予雷貝拉唑10 mg/次、阿莫西林1000 mg/次，2次/d，服用5 d，5 d後口服雷貝拉唑10 mg/次、剋拉黴素500 mg/次、呋喃唑酮100 mg/次，2次/d，再服用5 d，10 d後使用雷貝拉唑10 mg/次，1次/d，續服3週。對照組為標準三聯療法組：第1~10天給予奧美拉唑20 mg/次、阿莫西林1000 mg/次、呋喃唑酮100 mg/次，2次/d，第11~31天服用奧美拉唑20 mg/次，1次/d。治療結束後4週複查胃鏡，行快速尿素酶試驗和14C尿素呼氣試驗測定Hp，評估療效及安全性。結果：156例患者按方案完成治療。治療組按ITT分析Hp根除率為92.50%（74/80），明顯高于對照組的78.75%（63/80），差異有統計學意義（字2=19.262，P<0.01）。治療組按PP分析Hp根除率為94.87%（74/78），明顯高于對照組的80.77%（63/78），差異有統計學意義（字2=15.566，P<0.01）。治療組和對照組的不良反應髮生率分彆為18.75%（15/80）和22.50%（18/80），比較差異無統計學意義（P>0.05）。結論：雷貝拉唑、阿莫西林、呋喃唑酮、剋拉黴素組成的10 d序貫治療方案較奧美拉唑、阿莫西林、呋喃唑酮組成的標準三聯10 d治療方案更加能有效根除Hp，取得瞭很高的Hp根除率，治療效果佳，箇體差異小，不良反應髮生率低，患者依從性好，值得臨床上推廣應用。
목적：비교이뢰패랍서、아막서림、극랍매소、부남서동조성적10 d서관요법여오미랍서+아막서림+부남서동조성적10 d표준삼련요법근제유문라간균（Hp）적료효화안전성。방법：160례Hp감염활동성소화성궤양환자수궤분위치료조화대조조，매조80례。치료조위서관요법조：급여뢰패랍서10 mg/차、아막서림1000 mg/차，2차/d，복용5 d，5 d후구복뢰패랍서10 mg/차、극랍매소500 mg/차、부남서동100 mg/차，2차/d，재복용5 d，10 d후사용뢰패랍서10 mg/차，1차/d，속복3주。대조조위표준삼련요법조：제1~10천급여오미랍서20 mg/차、아막서림1000 mg/차、부남서동100 mg/차，2차/d，제11~31천복용오미랍서20 mg/차，1차/d。치료결속후4주복사위경，행쾌속뇨소매시험화14C뇨소호기시험측정Hp，평고료효급안전성。결과：156례환자안방안완성치료。치료조안ITT분석Hp근제솔위92.50%（74/80），명현고우대조조적78.75%（63/80），차이유통계학의의（자2=19.262，P<0.01）。치료조안PP분석Hp근제솔위94.87%（74/78），명현고우대조조적80.77%（63/78），차이유통계학의의（자2=15.566，P<0.01）。치료조화대조조적불량반응발생솔분별위18.75%（15/80）화22.50%（18/80），비교차이무통계학의의（P>0.05）。결론：뢰패랍서、아막서림、부남서동、극랍매소조성적10 d서관치료방안교오미랍서、아막서림、부남서동조성적표준삼련10 d치료방안경가능유효근제Hp，취득료흔고적Hp근제솔，치료효과가，개체차이소，불량반응발생솔저，환자의종성호，치득림상상추엄응용。
Objective:To compare the efficacy and safety of Rabeprazole-based 10-days sequential therapy including Rabeprazole,Amoxicillin,Clarithromycin,Furazolidone,with 10-days standard triple therapy including Omeprazole,Amoxicillin,Furazolidone in Helicobacter pylori.eradication.Method:A total of 160 Helicobacter pylori patients with infection in active peptic ulcer were recruited and randomly assigned into the treatment group and the control group,80 cases in each group.The treatment group(sequential therapy) was implemented with RA program which included orally taking Rabeprazole 10 mg per time,Amoxicillin 1000 mg per time,twice per day in the first five days, after the five days,the treatment group was implemented with RCF program which included orally taking Rabeprazole 10 mg per time,Clarithromycin 500 mg per time,Furazolidone 100 mg per time,twice per day for five days,then the treatment group was given Rabeprazole 10 mg once per day for three weeks.The control group(standard triple therapy) was implemented with OAF program which included orally taking Omeprazole 20 mg twice per day,Amoxicillin 1000 mg twice per day,Furazolidone 100 mg twice per day for 10 days,then the control group was given Omeprazole 20 mg,once per day for three weeks.Four weeks after the completion of treatment,the efficacy and safety were evaluated by gastroscopy, rapid urease test and14C urea breath test were determined for Helicobacter pylori.Result:A total of 156 patients completed the treatment.With intention-to-treat(ITT) analysis,the Helicobacter pylori eradication rate in the treatment group was 92.50%(74/80),which was significantly higher than 78.75%(63/80) of the control group,the difference was statistically significant( χ2=19.262,P<0.01).With per protocol(PP) analysis,the Helicobacter pylori eradication rate in the treatment group was 94.87%(74/78),which was significantly higher than 80.77%(63/78) of the control group,the difference was statistically significant( χ2=15.566,P<0.01).The incidence of adverse reaction rates of the treatment group and the control group were 18.75% (15/80) and 22.50%(18/80) respectively,there was no statistically significant difference(P>0.05).Conclusion:The 10-days sequential therapy including Rabeprazole,Amoxicillin, Clarithromycin,Furazolidone is more effective than 10-days standard triple therapy including Omeprazole,Amoxicillin, Furazolidone in eradicating Helicobacter pylori,can achieve a very high rate of Helicobacter pylori eradication and good curative effect.The individual difference is small,the incidence of adverse reaction is low,the patients’ compliance is good,it is worthy to be popularized in clinic.
