含米诺环素的四联方案在幽门螺杆菌感染复治中的应用价值

发布时间：2018-07-05 19:19

  本文选题：螺杆菌感染 + 幽门螺杆菌　； 参考：《中国全科医学》2017年18期

【摘要】：目的明确含米诺环素的四联方案在幽门螺杆菌(H.pylori)感染复治患者中应用的安全性、患者依从性、根除治疗成功率及其影响因素,以期为临床H.pylori感染复治患者的根除治疗提供新的选择。方法选择2013年8月—2015年8月于北京积水潭医院就诊的H.pylori感染复治患者180例为研究对象。采用含米诺环素的四联方案,具体为雷贝拉唑(10 mg/次,2次/d)+阿莫西林(1.0 g/次,2次/d)+米诺环素(0.1 g/次,2次/d)+枸橼酸铋钾(220 mg/次,2次/d);疗程14 d。治疗结束后3~7 d观察患者不良反应情况、依从性;治疗结束后4~12周通过意向性治疗(ITT)分析及遵循方案(PP)分析评估根除治疗成功率。结果 ITT分析纳入180例患者;6例患者因失联、未按时复查,4例患者因依从性差予以剔除,PP分析纳入170例患者。共有56例(31.1%)患者出现不良反应,其中腹泻者31例(55.4%),头晕失眠者28例(50.0%),上腹不适、恶心者各23例(41.1%),各不良反应在停药后均完全消失。依从性好者165例(91.7%)。ITT分析根除治疗成功率为79.4%(143/180),PP分析根除治疗成功率为84.1%(143/170)。女性患者PP分析根除治疗成功率高于男性(P0.05);不同年龄、吸烟情况、既往根除治疗次数、既往根除治疗方案患者PP分析根除治疗成功率比较,差异无统计学意义(P0.05)。多元Logistic回归分析结果显示,性别、年龄、吸烟情况、既往根除治疗次数、既往根除治疗方案均不是PP分析根除治疗成功率影响因素(P0.05)。结论含米诺环素的四联方案在H.pylori感染患者复治中有较好的根除治疗成功率,安全性及依从性尚可,是H.pylori感染患者复治的新选择。
[Abstract]:Objective to identify the safety of the four regimen of minocycline in the retreated patients with Helicobacter pylori (H.pylori), patient compliance, the success rate of eradication and its influencing factors, in order to provide a new choice for the eradication treatment of the retreated patients with clinical H.pylori infection. In August 2013 and August 2015, Fang method chose the Beijing quaitan medicine 180 patients with H.pylori infection were treated with a quadruple regimen including minocycline (10 mg/ times, 2 times /d) + amoxicillin (1 g/ times, 2 /d) + minocycline (0.1 g/ times, 2 /d) + bismuth citrate (220 mg/ times, 2 times / D), and 14 d. after the treatment of 14 D., 3~7 D observed the adverse reaction of patients after 3~7 D observed patients after treatment, depending on the course of treatment. After the end of the treatment, 4~12 weeks after 4~12 weeks were analyzed and followed by a program (ITT) analysis and program (PP) analysis to evaluate the success rate of eradication. Results ITT analysis was included in 180 patients; 6 patients were not rechecked because of loss of union, 4 patients were excluded because of poor compliance, and PP analysis was included in 170 patients. 56 cases (31.1%) had adverse reactions. 31 cases of diarrhea (55.4%), 28 cases of dizziness and insomnia (50%), upper abdominal discomfort, 23 cases of nausea (41.1%), all adverse reactions were completely disappeared after withdrawal. 165 cases with good compliance (91.7%).ITT analysis was 79.4% (143/180), and PP analysis was 84.1% (143/170). The success rate of PP analysis in female patients was high. There was no significant difference between men (P0.05), age, smoking, previous eradication times, and previous eradication therapy in patients with PP analysis, the difference was not statistically significant (P0.05). Multiple Logistic regression analysis showed that sex, age, smoking, previous eradication treatment times, and previous eradication treatments were not PP analysis. Conclusion the quadruple program containing minocycline has a good success rate of eradication, safety and compliance in the retreatment of H.pylori infected patients. It is a new choice for the retreatment of patients with H.pylori infection.
【作者单位】： 北京积水潭医院消化科;
【分类号】：R573
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本文编号：2101449