10天伴同、序贯及含铋剂四联方案根除幽门螺杆菌效果的随机对照研究

发布时间：2018-05-11 13:28

本文选题：幽门螺杆菌 + 伴同方案　；参考：《山东大学学报(医学版)》2014年07期

【摘要】：目的通过比较10天伴同、序贯及含铋剂四联疗法三种方案对Hp的根除率,以确定最佳的四联治疗方案,进而指导临床实践。方法经快速尿素酶检查证实Hp的患者随机接受伴同方案(奥美拉唑20 mg、阿莫西林1 000 mg、克拉霉素500 mg、替硝唑500 mg)、序贯方案(前5天为奥美拉唑20 mg、阿莫西林1 000 mg,后5天为奥美拉唑20 mg、克拉霉素500 mg、替硝唑500 mg)或含铋剂方案(奥美拉唑20 mg、阿莫西林1 000 mg、克拉霉素500 mg、胶体果胶铋200 mg)治疗,每日2次用药,疗程均为10 d。患者停药后6周进行13C呼气试验检查,结果阴性者判为根除成功。结果意向性分析时,伴同方案、序贯方案和含铋剂方案对Hp的根除率分别为85.6%、70.7%、85.3%,伴同方案和含铋剂方案均显著优于序贯方案(P0.05)。符合方案集分析显示,上述3组对Hp的根除率为87.8%、82.8%和88.9%,各方案之间的根除率均无统计学差异(P0.05)。结论在临床工作中,10 d含铋剂四联方案可作为经验性治疗Hp感染的首选方案。
[Abstract]:Objective to compare the eradication rate of HP with 10 day concomitant sequential and bismuth tetralogy in order to determine the best quadruple therapy and to guide clinical practice. Methods patients with HP confirmed by rapid urease test were randomly assigned to an accompanying regimen (omeprazole 20 mg, amoxicillin 1 000 mg, clarithromycin 500 mg, tinidazole 500 mg), sequential regimen (omeprazole 20 mg, amoxicillin 1 000). Omeprazole 20 mg, clarithromycin 500 mg, tinidazole 500 mg) or bismuth (omeprazole 20 mg, amoxicillin 1 000 mg, clarithromycin 500 mg, colloidal pectin bismuth 200 mg) for the next 5 days. The course of treatment was 10 days. A 13 C breath test was performed 6 weeks after withdrawal, and the negative patients were found to have been successfully eradicated. Results in the intentionality analysis, the eradication rates of HP by the concomitant scheme, the sequential scheme and the bismuth containing regimen were 85.6 / 70.7 / 85.3, respectively. The corresponding scheme and bismuth containing agent regimen were significantly superior to the sequential scheme (P 0.05). In accordance with the protocol set analysis, the eradication rate of HP in the above three groups was 87.8% and 88.9%, respectively. There was no significant difference in eradication rate among the three groups (P 0.05). Conclusion the tetralogy of bismuth containing bismuth can be used as the first choice in the treatment of HP infection.
【作者单位】：山东大学齐鲁医院消化内科;
【分类号】：R573.1

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