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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

22卷

期数:

2016年01期

页码:

41-43

栏目:

临床医学

出版日期:

2016-01-20

文章信息/Info

Title:

Clinical observation of four bismuth-based quadruple therapies for eradicate Helicobacter pylori

文章编号:

1006-8147（2016）01-0041-03

作者:

张芝华; 张志广; 李 熳; 田珺琪

(天津医科大学第二医院消化内科，天津 300211)

Author(s):

ZHANG Zhi-hua;  ZHANG Zhi-guang;  LI Man;  TIAN Jun-qi

(Department of Gastroenterology，The Second Hospital, Tianjin Medical University, Tianjin 300211，China)

关键词:

幽门螺旋杆菌; 四联疗法; 根除; 铋剂; 左氧氟沙星

Keywords:

H.pylori;  quadruple therapy; eradication;  bismuth; levofioxacin

分类号:

R57

DOI:

-

文献标志码:

A

摘要:

目的：观察和比较4种含铋剂四联方案根除幽门螺旋杆菌（H.pylori）的疗效、不良反应及成本-效果分析。 方法：收集行胃镜检查及¹³C-尿素呼气试验证实为H.pylori感染的441例患者的临床资料,所有患者均随机给予10 d含铋剂四联方案，即雷贝拉唑组（A组）和泮托拉唑组（B组），各组内又分为左氧氟沙星组（A1/B1组）和替硝唑组（A2/B2组）。治疗结束后，间隔4周行¹³C -尿素呼气试验复查H.pylori，同时观察治疗过程中不良反应。结果：A1、A2、B1、B2 4组Hp根治率按意向性治疗（ITT）分析，依次为79.4%、51.9%、82.4%、57.1%；按方案治疗（PP）分析，依次为83.3%、56.0%、85.7%、58.8%，A1组与A2组、B1组与B2组比较，差异均有统计学意义（P<0.05）；而A1组与B1组、A2组与B2组比较，差异均无统计学意义（P>0.05）。4组均未见明显不良反应。4组成本-效果比以A1组最低。结论：含左氧氟沙星及雷贝拉唑的铋剂四联方案根治率高，成本较低，效价比高。

Abstract:

Objective：To observe and compare the efficacy，adverse reactions and cost-effectiveness analysis of four bismuth-based quadruple therapies to eradicate Helicobacter pylori(H.pylori). Methods： The clinical date of 441 patients were collected； who underwent electronic gastrocope and were diagnosed as H.pylori infection by ¹³C -urea breath test. All of them were randomized to receive 10 days bismuth-based quadruple therapy. after which were divided into rabeprazole group (group A) and pantoprazole group (group B). Each group was stratified into levofloxacin group (A1/B1 group) and tinidazole group (A2/B2 group). ¹³C-urea breath test were performed four weeks after the treatment. Patients’ drug adverse reactions were observed and recorded. Results：According to ITT analysis， A1，A2,B1 and B2 the eradication rates of Group were 79.4%，51.9%，82.4% and 57.1% respectively，and according to PP analysis, results were 83.3%，56.0%，85.7% and 58.8%, respectively. We compared Group A1 with GroupA2 and GroupB1 with Group B2, differences were statistically significant (P<0.05)；While（改为We also） compared Group A1 with Group B1 and Group A2 with Group B2, and the differences were not statistically significant (P>0.05). There was no obvious adverse reaction in the four groups. The lowest Cost-effectiveness in the four groups was found in A1. Conclusion：The quadruple therapy containing both levofloxacin and rabeprazole has a higher eradication rate and lower cost.