含不同抗生素四联方案根除幽门螺杆菌的疗效比较

摘要

目的 比较临床常用3组幽门螺杆菌(Hp)根除方案(EBAF、EBAC、EBAT)在Hp感染患者中的根除情况、症状缓解情况和成本-效果及不良反应.方法 选取我院消化内科门诊Hp感染患者134例,按照数字随机法将Hp感染患者随机分成3组.患者均给予埃索美拉唑、枸橼酸铋钾胶囊、阿莫西林基础治疗,在基础治疗的同时,A组(EBAF)、B组(EBAC)、C组(EBAT)分别添加呋喃唑酮、克拉霉素、替硝唑治疗,疗程为10 d;停药1个月后复查呼气试验.结果 A组的Hp根除率、症状缓解率高于B组、C组,且成本-效果优于B组、C组,差异有统计学意义(P0.05).结论 三组根除Hp治疗方案中,EBAF方案的根除率高,成本-效果佳,且不良反应无明显增加,可作为一线方案用于临床根除Hp.%Objective To compare the effect of three quadruple therapies of H.pylori (Hp) eradication[esomeprazole-bismuth potassium citrate-amoxicillin-furazolidone (EBAF),esomeprazole-bismuth potassium citrate-amoxicillin-clarithromycin (EBAC) or esomeprazole-bismuth potassium citrate-amoxicillin-tinidazole (EBAT)] in terms of Hp eradication rate,symptom improvement,cost-effectiveness and adverse effects.Methods Totally 134 outpatients with H.pylori infection in our hospital were randomly assigned into 3 groups.All the patients were given esomeprazole,amoxicillin and bismuth potassium citrate capsules.Group A,group B and group C were also given furazolidone (EBAF),clarithromycin (EBAC) and tinidazole (EBAT),respectively,for 10 days.After discontinuation of the treatments for 4 weeks,breath tests were re-performed.Results The rates of Hp eradication and symptom improvement in group A were higher than those of group B and group C (P0.05).Conclusion Among the three groups,quadruple therapy with furazolidone shows a higher eradication rate and better cost-effectiveness without an increase in adverse effects.Therefore,it can be recommended as the first-line treatment for clinical eradication of Hp.