| 崔 英 沈曼茹 高振军 颜美珠△ 黄继英 唐 鄂 安 敏 喻 青.四联疗法和序贯疗法治疗服用非甾体类消炎药人群幽门螺杆菌感染的临
床对照研究[J].,2015,15(6):1105-1108 |
| 四联疗法和序贯疗法治疗服用非甾体类消炎药人群幽门螺杆菌感染的临
床对照研究 |
| Quadruple Therapy and Sequential Therapy in the Treatment ofin Patients Receiving Long-term Non-steroidal Anti-inflammatoryDrugs Treatment: a Controlled Clinical Study |
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| DOI： |
| 中文关键词: 幽门 螺杆菌 非甾 体消炎药 四联疗法 序贯疗 法 根除率 |
| 英文关键词: Non-steroidal anti-inflammatory angents Quadruple therapy Sequential therapy Eradication rate |
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| 中文摘要: |
| 目的： 对比四联疗法和序贯疗法对根除服用 非甾 体类消炎药 (NSAID)人群幽门 螺杆菌(Hp)，改善其消化道不良症状及促进消
化性溃疡愈合的临床效果。 方法： 对有消化不良症状的服用 非甾 体类消炎药物患者行胃 镜检查、快速尿激酶及 1 3C 呼气试验检
查， 将 155 例幽门 螺杆菌阳性合并有慢性胃炎或消化性溃疡患者作为研究对象， 随机分为 两组， A 组采用 四联疗 法， B 组采用 序贯
疗 法。 A 组予雷贝 拉唑 + 克拉霉素 + 阿莫西林 + 枸橼酸铋钾治疗 10 天； B 组前 5 天予雷贝 拉唑 + 阿莫西林，后 5 天予雷贝 拉唑 +
克拉霉素 + 甲硝唑。治疗结束后， 予雷贝 拉唑和胃 黏膜保护剂治疗 8 周。停药 4 周后，复查胃 镜、 13C 呼气试验， 观察和比较两组 Hp
根除率、 消化不良症状缓解率及溃疡愈合率。 结果： A、 B 两组 Hp 根除率分别 为 (ITT 分析： 86.7 %和 81 .9 %； PP 分析： 87.8 %和
84.3 %)；症状缓解率为 (81 .9 %对 79.2 %)； 胃 溃疡愈合率为 (68.8 %对 66.7 %)，十二指肠球部溃疡的愈合率为 (68.2 %对 70.0 %)， 两
组患者间 Hp 根除率、症状缓解率及溃疡愈合率比较均未见明显统计学差异(P>0.05)。 四联疗 法组和序贯疗法组不良反应的发生
率分别为 4.9 %和 4.3 %。 两组比较无明显差异(P>0.05)。 结论： 四联疗 法和序贯疗 法对长期服用 非甾 体类消炎药物人群的 Hp 根除
疗 效、消化不良症状的缓解及促进溃疡愈合的治疗作用 均无明显差异。 |
| 英文摘要: |
| Objective:To assess the efficacy of quadruple therapy and sequential therapy in the eradication of ,
symptoms relieve rates and ulcer healing rates in patients receiving long-term non-steroidal anti-inflammatory drugs treatment.Methods:Patients receiving long-term NSAID treatment with dyspeptic symptoms underwent endoscopy, rapid urease test (RUT) and 13C-urea
breath test (13C -UBT). Patients diagnosed as Hp infection and also with chronic gastritis or peptic ulcer were enrolled in this study and
divided into two groups. In group A, patients received quadruple therapy (rabeprazole ,clarithromycin, amoxicillin and bismuth subcitrate
for 1 0 days); in group B, patients received sequential trerapy (rabeprozol and amoxicillin for the first 5 days, rabeprazole,clarithromycin
and metronidazole for the next 5 days). All patients were given rabeprazole and mucosal protective therapy as maintenance treatment
after eradication therapy for 8 weeks. Patients re-examined endoscopy, rapid urease(RUT) and 13C-urea breath test(1 3C -UBT) 4 weeks
after the treatment. The Hp eradication rate, remission of clinical symptoms and ulcer healing were assessed.Results:No statistical
difference was observed in the Hp eradication rates between group A and group B on both ITT analysis (86.7 % vs. 81.9 %) and PP
analysis (87.8 % vs. 84.3 %). There was no difference between the two groups in the symptoms remission rates (81.9 % vs. 79.2 %) and
the ulcer healing rates, including the stomach ulcer (68.8 % vs. 66.7 %) and the duodenal ulcer (68.2 % vs. 70.0 %). No significant
difference was found in the incidence rates of adverse reactions between two groups(P>0.05).Conclusion:There was no difference in the
Hp eradication, remission of clinical symptoms and ulcer healing between quadruple therapy and sequential therapy in patients receiving
long-term non-steroidal anti-inflammatory drugs treatment. |
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