目的 探讨序贯疗法治疗幽门螺杆菌(Hp)阳性消化性溃疡(PU)的疗效及安全性.方法 86例Hp阳性PU患者按随机数字表法分为对照组(泮托拉唑+阿莫西林+克拉霉素)和观察组(前5d泮托拉唑+阿莫西林,后5d泮托拉唑+替硝唑+克拉霉素)各43例.以10 d作为1个疗程,疗程结束后一个月,对两组患者Hp转阴情况、疗效及治疗期间的不良反应进行比较.结果 对照组Hp根除率76.7%,观察组Hp根除率88.4%,差异有统计学意义(χ2=4.725,P<0.05);对照组总有效率79.1%,观察组总有效率90.7%,差异有统计学意义(χ2=5.114,P<0.05).两组不良反应比较差异无统计学意义(P>0.05).结论 Hp阳性PU采用序贯疗法治疗具有较高的Hp根除率及治疗有效率,无明显不良反应,值得临床进一步研究与推广运用.%Objective To study the efficacy and safety of a sequential therapy in the treatment of Helicobacter pylori ( Hp) positive peptic ulcer ( PU) .Methods A total of 86 patients with Hp positive PU were randomly divided into control group ( panto-prazole +amoxicillin+clarithromycin) and observation group ( pantoprazole +amoxicillin in the first 5 days followed by pantoprazole +clarithromycin +tinidazole for another 5 days) ,43 in each group .Ten days were taken as one therapy course .After one month of the treatments,the status of Hp from positive to negative ,curative effect,treatment period,and adverse reactions were compared between the two groups .Results In the control group , Hp eradication rate was 76.7% that was significantly lower than that in the observation group (88.4%) (χ2=4.725,P<0.05).The total effective rate in the control group was 79.1% while the rate in the observation group was 90.7%.The difference was statistically significant (χ2=5.114 ,P<0.05 ) .No significant difference in adverse reactions was found between the two groups .Conclusion The sequential therapy for Hp positive PU has a relative high Hp eradication rate ,total ef-fective rate and no significant adverse reactions .It is worthy of further study and clinical application .
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