序贯疗法治疗幽门螺杆菌阳性胃溃疡的临床分析
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【摘要】目的比较序贯疗法与传统三联疗法治疗幽门螺杆菌(Hp)阳性胃溃疡的疗效与安全性。方法选取84例经胃镜检测证实为Hp阳性胃溃疡病例，随机分为两组：治疗组，前5d予雷贝拉唑、阿莫西林,后5d予雷贝拉唑、替硝唑、克拉霉素治疗；对照组予雷贝拉唑、阿莫西林、克拉霉素治疗10d。随后两组均进行雷贝拉唑巩固治疗4周，疗程结束后均行胃镜复查检测。结果疗程结束时,治疗组溃疡愈合率87.8%,对照组溃疡愈合率86.05%，两组愈合率比较无显著性差异(P>0.05)；治疗组HP阴转率为92.68%,对照组HP阴转率为83.72%，两组HP阴转率比较具有显著性差异(P<0.05)。结论10d序贯疗法治疗Hp的HP阴转率较传统三联疗法高, 溃疡愈合率相当，且副作用少,易耐受,安全可靠。
【关键词】10d序贯疗法；三联疗法；幽门螺杆菌；胃溃疡
Sequential therapies for Helicobacter pylori-positive gastric ulcer clinical analysis
【Abstract】Objective To compare sequential therapy with the traditional triple therapies for Helicobacter pylori (Hp)-positive gastric ulcer and security. Methods 84 cases detected by endoscopy confirmed Hp-positive patients with gastric ulcer were randomly divided into two groups: the treatment group，before the therapy of the combination of rabeprazole, amoxicillin and rabeprazole for 5d,tinidazole, clarithromycin mixture therapy of 5d;control group, rabeprazole, Amoxicillin,clarithromycin treatment of 10d. Both groups were followed for consolidation therapy of rabeprazole for 4 weeks after treatment underwent endoscopy review test. Results at the end of treatment, the treatment group 87.8% ulcer healing rate, ulcer healing rate of the control group was 86.05%, the healing rate between the two groups there was no significant difference (P>0.05); treatment group HP negative conversion rate was 92.68%, control Group HP negative conversion rate was 83.72%, compared two groups of HP negative rate was significant difference (P <0.05). Conclusion 10d sequential therapy of HP Hp negative rate higher than the traditional triple therapy, ulcer healing rate is quite, the side effects is less, tolerable, safe and reliable.
【Keywords】10d sequential triple therapy for Helicobacter pylori in gastric ulcer treatment
幽门螺杆菌(Helicobacter pylori, Hp)是消化性溃疡、胃癌、胃黏膜相关淋巴组织(MALT)淋巴瘤等疾病的重要致病因子, 对消化性溃疡患者的治疗必须根除Hp。目前，随着细菌耐药率的逐年升高, Hp根除的一线方案的Hp根除率也在下降, 已有文献报道标准三联疗法Hp根除率已下降至66.6%[1]。因此,需要寻找一种更理想的Hp根除的一线方案。由意大利DeFrancesco et al[2]发现的根除Hp的新方案-序贯疗法,可以取得更高的H pylori根除率。不同国家或地区Hp对主要抗菌素的耐药状况有明显差异[3],因此国外序贯疗法的经验和资料并不一定适合中国 ......
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