【摘要】 目的观察序贯疗法对幽门螺杆菌(Helicobacter pylori,Hp)感染的治疗和根治效果。方法选择无锡市第四人民医院经胃镜检查确诊为慢性胃炎、消化性溃疡且Hp感染阳性患者92例,随机分为序贯疗法组(治疗组)和标准三联疗法组(对照组)2组。治疗组45例,给药方案:前5 d,埃索美拉唑20 mg+阿莫西林1 000 m g,日2次;后5 d,埃索美拉唑20 mg+克拉霉素500 mg+替硝唑500 mg,日2次;对照组47例,采用标准三联疗法:埃索美拉唑20 mg+克拉霉素500 mg+阿莫西林1 000 mg,日2次,疗程7 d。所有患者停药4周后复查,观察2组患者治疗的总有效率;采用13C-尿素呼气试验判断Hp感染根治效果,观察Hp根除率。结果2组患者治疗的总有效率,治疗组为95.56%,对照组为91.48%,两组差异无统计学意义(χ2=0.528,P>0.05)。Hp根除率治疗组为93.33%,对照组为78.72%,差异有统计学意义(χ2=4.040,P<0.05)。不良反应治疗组出现7例,发生率为15.56%,对照组8例,发生率为17.02%,差异无统计学意义(χ2=0.008,P>0.05)。治疗组平均每例患者治疗费用为165.90元/人,对照组为171.78元/人,费用基本相同。结论序贯疗法治疗Hp感染疗效明显,是一种有效、安全、经济的Hp感染根除疗法。更多还原

【Abstract】 Objective To observe the effect of sequential therapy for eradical treatment of Helicobacter pylori(Hp) infection.Methods A total of 92 patients infected with H.pylori who had active chronic gastritis with known peptic ulcer as confirmed by gastroscopy.Patients were randomly divided into a sequential therapy group(therapy group) and the triple therapy group(control group).45 cases of sequential therapy group accepted esomeprazole(20 mg b.d.) plus amoxicillin(1g b.d.) for 5 days,followed by esomeprazole(20mg b.d.),clarithromycin(500mg b.d.) and tinidazole(500mg b.d.) for the remaining 5 days.47 cases of standard triple therapy treated with esomeprazole(20mg b.d.) plus clarithromycin(500mg b.d.) and amoxicillin(1g b.d.) for 7 days.All drugs were given twice daily.All these patients received 13C urea breath test(13C-UBT) four weeks after treatment.Results The total effective rate of treatment were 95.56% and 91.48% in the sequential therapy group and control group respectively(χ2 = 0.528,P > 0.05).Hp infection eradication rate were 93.33% and 78.72% respectively,(χ2 =4.040,P<0.05).The incidence of side effects were 15.56% and 17.02% respectively(χ2 =0.008,P>0.05).Sequential therapy group of economic burden was 165.90 yuan / person and that of the control group was 171.78 yuan / person.Conclusion The curative effect of sequential therapy for eradication of Hp infection is significant.It is a safe,economic and effective for eradication of Hp infection.更多还原