不同剂量抗生素治疗幽门螺杆菌的临床观察及经济学评价

发布时间：2018-03-05 17:44

本文选题：幽门螺杆菌　切入点：三联疗法　出处：《石河子大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：本实验主要通过临床观察为期10天的标准剂量抗生素联合抑酸药与小剂量抗生素联合抑酸药治疗幽门螺杆菌，来评估标准剂量与小剂量抗生素联合抑酸药治疗方案治疗幽门螺杆菌的根治率、不良反应、依从性、成本的影响差异。方法：选择我院2011年6月至2012年6月幽门螺杆菌感染患者108例，将其随机分为两组：A组(标准剂量)，兰索拉唑(15mg)，阿莫西林(1g)，克拉霉素(500mg)，一日两次，疗程10天；B组(小剂量)，，兰索拉唑(15mg)一日两次，阿莫西林(500mg)，克拉霉素(250mg)，一日三次，疗程10天。停药至少4周后或停用抑酸药至少2周后行尿素呼气试验(UBT)。对整个治疗期间的依从性及不良反应、成本进行评估。结果：108例幽门螺杆菌感染患者(男54人，女54人；平均年龄51.6±12.2岁)，随机分为A组(标准剂量组)；B组(小剂量组)。 1．经治疗后：ITT分析，A组、B组的根除率分别是83.3％(45/54)、81.5％(44/54)，差异无统计学意义(P=1.00)。PP分析，A组、B组的根除率分别是84.9％(45/53)、86.3％(44/51)，差异无统计学意义(P=1.00)。 2．经过10天的治疗后发现标准剂量组的不良反应发生率明显高于小剂量组，A组62.3%，B组18.2%(P0.05)。 3． A组(标准剂量组)；B组(小剂量组)治疗10天后的费用分别为(327.6元、258.6元)。结论： 1.小剂量的抗生素联合抑酸药方案与标准剂量的抗生素相比，根除幽门螺杆菌是有效的，但两种治疗方案与公认的标准根治率相比均不理想。 2．小剂量抗生素联合抑酸药与标准剂量联合抑酸药方案相比，不良反应发生率及依从性更好； 3．小剂量组与标准剂量组相比成本较低。
[Abstract]:Objective: to treat Helicobacter pylori by clinical observation of 10 days standard antibiotics combined with acid suppressants and small doses of antibiotics combined with acid suppressants. To assess the effects of standard doses and low doses of antibiotics combined with acid suppressants on the cure rate, adverse reactions, compliance, and cost of Helicobacter pylori. Methods: one hundred and eight patients with Helicobacter pylori infection from June 2011 to June 2012 in our hospital were randomly divided into two groups: group A (standard dose), lansoprazole 15 mg / g, amoxicillin 1 g, clarithromycin 500 mg / g, 1st, respectively. The course of treatment was 10 days in group B (small dose of lansoprazole 15 mg), twice in 1st, amoxicillin 500 mg / g, clarithromycin 250 mg / g, 1st, 3 times; The course of treatment was 10 days. Urea breath test (UBTT) was performed after at least 4 weeks of withdrawal or at least 2 weeks after discontinuation of acid suppressants. Compliance and adverse reactions and costs of the whole treatment period were evaluated. Results one hundred and eight patients with Helicobacter pylori infection (male 54, female 54; mean age 51.6 卤12.2 years) were randomly divided into group A (standard dose group) and group B (small dose group). 1. After treatment, the eradication rates of group A and group B were 83.3 / 54 and 81.5 / 54, respectively. There was no significant difference in eradication rate between group A and group B (P = 1.00). PP analysis showed that the eradication rates of group A and B were 84.9% / 5386.34454 / 51, respectively, and there was no significant difference between two groups (P = 1.00). 2. After 10 days of treatment, it was found that the incidence of adverse reactions in the standard dose group was significantly higher than that in the low dose group (62.3B). 3. The cost of group A (standard dose group) and group B (small dose group) after 10 days treatment were 327.6 yuan / 258.6 yuan respectively. Conclusion:. 1. It is effective to eradicate Helicobacter pylori compared with the standard dose of antibiotics in combination with low dose antibiotics, but the two treatments are not ideal compared with the accepted standard cure rate. 2. The incidence of adverse reactions and compliance of low dose antibiotics combined with acid suppressants were better than those of standard dosage combination. 3. The cost of low dose group was lower than that of standard dose group.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R516

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