贵州医科大学学报

2017, v.42;No.200(05) 588-591

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3种四联方案根除幽门螺杆菌的效果及安全性观察
Curative Effect and Safety of 3 Combinations of 4 Antibiotics in Eradication of Helicobactor pylori

陈菲;潘晨;王瑞睿;姚怡然;王岚;刘琦;杨杰;
CHEN Fei;PAN Chen;WANG Ruirui;YAO Yiran;WANG Lan;LIU Qi;YANG Jie;Department of Gastrointestinal Medicine,the Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:探索阿莫西林联合克拉霉素、四环素联合呋喃唑酮、氧氟沙星联合庆大霉素4种抗生素组合对根除幽门螺杆菌(H.Pylori)的疗效及安全性。方法:选择C14呼气试验阳性的H.pylori感染、并伴有消化不良症状患者210例,采用分段随机法分为3组,A组使用阿莫西林联合克拉霉素治疗,B组使用四环素联合呋喃唑酮治疗,C组使用氧氟沙星联合庆大霉素治疗,各组均加入兰索拉唑及胶体果胶铋,疗程14 d;治疗结束4周后复查C14呼气试验,阴性者为H.pylori根除成功;记录并比较3组患者H.pylori行意向性(ITT)及符合方案(PP)根除率、症状缓解率,不良反应ITT及PP发生率。结果:与A、C两组治疗方案比较,B组ITT和PP根除率最高(P<0.05);3种治疗方案的症状缓解率均高于80%,各种治疗方案比较,差异无统计学意义(P>0.05);不良反应发生率B组最高,但3组间比较,差异无统计学意义(P>0.05),且所有不良反应均于停药后消失。结论:3种四联方案治疗H.Pylori感染并消化不良症的安全性较好,其中四环素联合呋喃唑酮方案H.pylori根除率最高。
Objective: To explore the curative effect and safety of 3 combinations of antibiotics(amoxicillin combined with clarithromycin,tetracycline combined with furazolidone,ofloxacin combined with gentamicin) in the eradication of Helicobacter pylori(H. pylori). Method: 210 cases of patients with H. pylori infection in positive C14 breath test and digestive symptoms were selected and divided into 3 groups by piecewise stochastic method. Group A adopted amoxicillin combined with clarithromycin treatment,group B tetracycline combined with furazolidone treatment,and group C ofloxacin combined with gentamicin treatment. The lansoprazole and colloidal bismmth pectin were added into the three groups. The process of treatment lasted 14 d. 4 weeks after treatment,C14 breath test was adopted again to reexamine. Negative meant successful eradication of H. pylori. The intention to treat(ITT) and per-protocol(PP) eradication rate,symptom remission rate and the incidence of adverse reaction ITT and PP in three groups have been recorded and compared,respectively. Results: Compared with group A and group C,in group B the ITT and PP eradication rate was the highest(P < 0. 05);The symptom remission rates in 3 groups were all more than 80%,and there was no statistically significant difference between the three groups(P > 0. 05). The incidence rate of adverse reaction in group B was the highest,but there was no statistically significant difference between the 3 groups. All adverse reactions disappeared after drug withdrawal. Conclusions: The safety of three combinations of 4 antibiotics in the treatment of H. pylori infection and dyspepsia is relatively good,of which the eradicationrate of H. pylori by tetracycline combined with furazolidone is the highest.

关键词(KeyWords): 四环素;幽门螺杆菌;四联疗法;耐药率;根除率
tetracycline;Helicobactor pylori;quadruple therapy;drug resistance rate;eradication rate

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作者(Author): 陈菲;潘晨;王瑞睿;姚怡然;王岚;刘琦;杨杰;
CHEN Fei;PAN Chen;WANG Ruirui;YAO Yiran;WANG Lan;LIU Qi;YANG Jie;Department of Gastrointestinal Medicine,the Affiliated Hospital of Guizhou Medical University;

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