杨麒臻,周力,刘苓
YANG Qizhen,ZHOU Li,LIU Ling

• 1:贵州医科大学
• 2:贵州医科大学附院消化内科
• 3:四川大学华西医院

摘要(Abstract)：

目的:评价含阿莫西林和铋剂的四联方案根除幽门螺杆菌(H.pylori)的有效性及安全性。方法:将300例H.pylori感染患者随机分成5组,每组均用兰索拉唑、胶体果胶铋混悬剂,在此基础上A组加用阿莫西林、克拉霉素,B组加用阿莫西林、左氧氟沙星,C组加用阿莫西林、庆大霉素,D组加用阿莫西林、呋喃唑酮,E组加用阿莫西林、克拉霉素;A、B、C、D组疗程10 d,E组疗程14 d,记录H.pylori根除率及不良反应,计算成本/效果比值(C/E)。结果:A、B、C、D、E组H.pylori根除率分别为65.38%(34/52)、79.66%(47/59)、78.18%(43/55)及86.00%(43/50)、74.62%(50/67),各组不良反应差异无统计学意义(P>0.05),C/E依次为5.254、4.334、4.292、3.329及5.593。结论:含阿莫西林、呋喃唑酮的铋剂四联方案治疗,对H.pylori感染的根除率高于含阿莫西林、克拉霉素的铋剂四联方案,兰索拉唑、铋剂、阿莫西林、呋喃唑酮方案最经济有效。
Objective: To investigate the effects and safety of quadruple therapy with amoxicillin and bismuth on Helicobacter pylori( H. pylori) eradication. Methods: A total of 300 patients infected with H. pylori were treated with quadruple therapy including amoxicillin and bismuth. They were divided into five groups and treated with Lansoprazole and Bismuth pectin. Group A was treated with extra amoxicillin and clarithromycin,group B was treated with extra amoxicillin and levofloxacin; group C was treated with extra amoxicillin and gentamicin,group D was treated with extra amoxicillin and furazolidone,group E was treated with extra amoxicillin and clarithromycin. Therapy duration for group A,B,C,D was 10 days,and 14 days for group E. Recording eradication rate,adverse reaction and cost. Results: The eradication rates of five groups were 65. 38%( 34 /52),79. 66%( 47 /59),78. 18%( 43 /55),86. 00%( 43 /50) and 74. 62%( 50 /67) respectively. There was no statistial significance on adverse reaction( P > 0. 05). C / E were 5. 254,4. 334,4. 292,3. 329,and 5. 593 respectively. Conclusion: The H. pylori eradication of amoxicillin-furazolidone bismuth quadruple therapy is higher than amoxicillin-clarithromycin bismuth quadruple therapy. The therapy of lansoprazole,bismuth pectin,amoxicillin,furazolidone is low cost-effective.

关键词(KeyWords)： 螺杆菌,幽门;铋剂;抗生素;阿莫西林
Helicobacter pylori;bismuth;antibiotics;amoxicillin

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 杨麒臻,周力,刘苓
YANG Qizhen,ZHOU Li,LIU Ling

DOI: 10.19367/j.cnki.1000-2707.2015.10.020

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