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含左氧氟沙星的序贯疗法根除幽门螺杆菌的临床观察(1)
http://www.100md.com 2011年5月15日 唐源 张银杰


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     [摘要]目的比较泮托拉唑、阿莫西林、左氧氟沙星、呋喃唑酮组成的10日序贯疗法与标准三联疗法根除幽门螺杆菌(H.pylori )的疗效和安全性。方法将我院经胃镜及病检确诊为慢性胃炎和消化性溃疡且H.pylori阳性的患者69例随机分为两组。治疗组(35例)方案:前5d,泮托拉唑40mg+阿莫西林1000mg,每日2次;后5d,泮托拉唑40mg+左氧氟沙星200 mg+呋喃唑酮100mg,每日2次。对照组(34例)方案:予标准三联疗法:泮托唑40mg+克拉霉素500mg+阿莫西林1000mg,每日2次,疗程7d。所有患者停药4周后复查14C呼气试验,判断H.pylori根除率。结果治疗组H.pylori 根除率为94.28%,6例发生轻微不良反应(17.14%),对照组76.47%,5例发生轻微不良反应(14.71%)。两组根除率比较差异具有统计学意义(χ2=4.97,P<0.05),不良方应的发生率比较无明显差异(χ2=0.05,P>0.05),且未增加治疗组的经济负担。结论含左氧氟沙星的序贯疗法治疗H.pylori 感染明显优于7日标准三联疗法,是一种有效、安全、经济的可选方案。

    关键词:左氧氟沙星呋喃唑酮泮托拉唑序贯疗法幽门螺杆菌

    [Abstract]Objective To determine whether the sequential therapy is better than the standard triple-drug therapy in treatment of H pylori infection for adults with chronic gastritis and peptic ulcer.MethodsSixty-nine patients with H pylori positive were randomly divided two groups. Thirty five patients received a 10-day sequential therapy [Pantoprazole 40 mg, twice daily) plus amoxicillin (1000 mg, twice daily) for the first 5 days, followed by (Pantoprazole 40 mg),Levofloxacin(200 mg) and Furazolidone (100mg) twice daily for the remaining 5 days]. Thirty-four patients received a 7-day triple therapy [Pantoprazole (40 mg), clarithromycin (500 mg) and amoxicillin 1000 mg, twice daily]. H pylori eradication was checked four weeks after treatment using 14C-urea breath test.。ResultsThe eradication rate of the sequential therapy With levofloxacin was 94.87%,adverse reaction wer17.14%e and merely 77.50% for the control group. The difference between the two groups was significant (χ2 = 4.97, P < 0.05). The two groups adverse reaction were17.14% and 14.71%. There was no difference in incidence of side effects between the two groups (χ2 = 0.05, P > 0.05). The all of adverse reaction was slight. ConclusionThe Sequential therapy With levofloxacin achieves a higher eradication rate than the standard triple therapy for the first time in adults. It is an effective, safe and economical option for patients and possesses great potential.

    Key words:LevofloxacinFurazolidonePantoprazoleSequential Treatment Helicobacter Pylori

    中图分类号:R573文献标识码:B文章编号:1004-7484(2011)10-0051-04 ......

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