两种三联疗法、不同疗程根除Hp的效果观察

发布时间：2018-07-23 11:28

【摘要】：目的:运用不同疗程的传统三联疗法与含左氧氟沙星三联疗法对幽门螺杆菌(Hp)感染的患者进行Hp根除,通过Hp根除率、临床症状缓解率、不良反应发生率,分析不同疗程的两种三联疗法根除Hp的效果。方法:收集2015年10月至2016年6月期间,经14C呼气试验检测,确诊为Hp感染的患者240例,将其随机平均分为RCA-7天、RCA-14天、RCL-7天和RCL-14天组。其中RCA-7天与RCA-14天组采用雷贝拉唑+克拉霉素+阿莫西林,疗程分别为7天与14天;RCL-7天与RCL-14天组患者采用雷贝拉唑+克拉霉素+左氧氟沙星,疗程分别为7天与14天。对比不同疗程的两种三联疗法的Hp根除率、临床症状缓解率及不良反应发生率。结果:收集有效患者229例。在Hp根除的影响因素中,男性Hp根除率高于女性;各年龄层Hp根除率在55.2%-76.2%;非吸烟患者Hp根除率高于吸烟患者,初中以上学历患者Hp根除率高于初中以下患者,消化性溃疡患者Hp根除率高于慢性胃炎患者。影响因素经过Logistic回归分析后得出,吸烟、学历和疾病种类可影响Hp根除。在相同疗程、不同方法中,RCA-7d组与RCL-7d组的Hp根除率分别为69.0%与50.8%((49)0.05),RCA-14d组与RCL-14d组的Hp根除率分别为84.2%与61.8%((49)0.05);在相同方法、不同疗程中,RCA-7d组与RCA-14d组的Hp根除率分别为69.0%与84.2%(P0.05),RCL-7d组与RCL-14d组的Hp根除率分别为50.8%与61.8%(P0.05)。治疗期间,77.7%患者临床症状得到改善,各组临床症状缓解率在74.1-82.5%,无论是两种疗程,亦或两个方法,患者临床症状缓解率差异均无统计学意义(P0.05)。11.3%患者出现不良反应,各组不良反应发生率在6.8-15.8%,无论是两种疗程,亦或两个方法,患者不良反应发生率差异均无统计学意义(P0.05)。结论:性别与年龄不影响Hp根除率,吸烟与低学历可降低Hp根除率,疾病类型可影响Hp根除率。Hp根除方案的选择,建议选用传统三联疗法,不建议选用含左氧氟沙星三联疗法。Hp根除疗程的选择,建议选用7天疗程。两种疗法临床症状缓解率高,不良反应少
[Abstract]:Objective: to eradicate Hp in patients with Helicobacter pylori (Hp) infection by traditional triple therapy with different courses of therapy and levofloxacin, through the eradication rate of Hp, the rate of clinical symptoms, the incidence of adverse reactions, and to analyze the effect of two kinds of triple therapy on the eradication of Hp. Methods: to collect the period from October 2015 to June 2016. The 14C expiration test was used to detect 240 patients with Hp infection, which were randomly divided into RCA-7 days, RCA-14 days, RCL-7 days and RCL-14 days, among which, RCA-7 days and RCA-14 days were treated with rizole + clarithromycin + amoxicillin, respectively, for 7 days and 14 days, and the patients of RCL-7 days and RCL-14 days were treated with rizole + clarithromycin + left oxyfluoro sand. The Hp eradication rate, the rate of clinical symptom relief and the incidence of adverse reactions were compared with two kinds of triple therapy for different courses. Results: 229 cases of effective patients were collected. Among the factors affecting the eradication of Hp, the rate of male Hp eradication was higher than that of women; the rate of Hp eradication in all ages was 55.2%-76.2%; the rate of Hp eradication in non smoking patients was higher than that of sucking. The eradication rate of Hp in patients with junior high school education was higher than those in junior middle school, and the rate of Hp eradication in patients with peptic ulcer was higher than that of chronic gastritis patients. After Logistic regression analysis, smoking, education and disease types could affect the eradication of Hp. In the same course of treatment, the rate of Hp eradication in the RCA-7d and RCL-7d groups was 69, respectively. .0% and 50.8% (49) 0.05, Hp eradication rates in group RCA-14d and RCL-14d group were 84.2% and 61.8% (49) 0.05, respectively. In the same method, the Hp eradication rate of RCA-7d group and RCA-14d group was 69% and 84.2% (P0.05), and Hp eradication rate in RCL-7d group and RCL-14d group was 50.8% and 61.8% (P0.05) respectively. The clinical symptoms of 77.7% patients were obtained during the treatment period. Improvement, the remission rate of clinical symptoms in each group was 74.1-82.5%, no matter two courses or two methods, there was no statistically significant difference in the rate of remission of the patients' clinical symptoms (P0.05).11.3% patients had adverse reactions. The incidence of adverse reactions in each group was 6.8-15.8%, no matter two treatments or two methods, the incidence of adverse reactions in the patients was all different. No statistical significance (P0.05). Conclusion: sex and age do not affect the eradication rate of Hp, smoking and low education can reduce the eradication rate of Hp, the type of disease can affect the selection of the eradication scheme of Hp eradication rate.Hp, recommend the choice of the traditional triple therapy, do not recommend the choice of the treatment course containing the triple therapy containing levofloxacin, 7 days of treatment. The remission rate of the clinical symptoms is high and the adverse reaction is less.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R57

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