| 摘要: |
| 目的观察不同四联药物和疗程方案根除幽门螺杆菌（Hp）的疗效，为临床上选择合理、有效的方案提供参考。方法选取初次治疗﹑Hp检测阳性的慢性胃炎或消化性溃疡患者306例，随机分为6组：A组阿莫西林胶囊加克拉霉素片、B组阿莫西林胶囊加左氧氟沙星片﹑C组阿莫西林胶囊加多西环素片，均联合艾司奥美拉唑肠溶片、枸橼酸铋钾胶囊，2次/d，疗程14d；D组阿莫西林胶囊加克拉霉素片﹑E组阿莫西林胶囊加左氧氟沙星片﹑F组阿莫西林胶囊加多西环素片，均联合艾司奥美拉唑肠溶片、枸橼酸铋钾胶囊，2次/d，疗程10d。疗程结束4周后复查13C呼气试验，观察Hp根除率、不良反应和成本-效果比（C/E）。结果按治疗方案分析，6组的Hp根除率比较差异有统计学意义（P＜0.05）；A、B、C3组及D、E、F3组的Hp根除率比较差异均有统计学意义（均P＜0.05）；同一方案不同疗程两两比较（A与D组、B与E组、C与F组）Hp根除率的差异均无统计学意义（均P＞0.05）。各组间不良反应均少见且轻微，发生率的差异无统计学意义（P＞0.05）；但F组C/E高于其他各组。结论阿莫西林、多西环素联合埃索美拉唑、枸橼酸铋钾胶囊10d方案根除Hp疗效较好，成本较低。 |
| 关键词: 幽门螺杆菌 阿莫西林 多西环素 四联疗法 |
| DOI：10.12056/j.issn.1006-2785.2018.40.6.2017-2706 |
| 分类号: |
| 基金项目:浙江省医药卫生平台计划项目（2015DTA020） |
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| Efficacy of quadruple therapy containing doxycycline and amoxicillin for Helicobacter pylori eradication |
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Wenzhou Medical University
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| Abstract: |
| Objective To evaluate the efficacy of different quadruple therapy regimes in treatment of patients with Helicobacter pylori (Hp) infection. Methods Three hundred and six chronic gastritis or peptic ulcer patients with positive Hp infection for initial treatment were randomly assigned to 6 groups with 51 cases in each：patients in group A (Amoxicillin capsules + Clindamycin tablets), group B (Amoxicillin capsules + Levofloxacin tablets), group C (Amoxicillin capsules + Doxycycline tablets) were also received esomeprazole enteric coated tablets and bismuth potassium citrate capsules, b.i.d for 14d; patients in group D (Amoxicillin capsules + Clindamycin tablets), group E (Amoxicillin capsules + Levofloxacin tablets) and
group F (Amoxicillin capsules+ Doxycycline tablets) also received esomeprazole enteric coated tablets and bismuth potassium citrate capsules, b.i.d for 10d. Four weeks after treatment, 13C breath tests were performed to observe the Hp eradication, adverse reactions were documented and cost-effectiveness ratio (C/E) was assessed. Results The differences in eradication rates among the 6 groups were statistically significant (P＜0.05); the differences of eradication rate among groups A, B, C and among groups D, E, F were also statistically significant (all P＜0.05); however, there were no significant differences between groups A and D, between B and E, and between C and F (all P ＞0.05). The adverse reactions were rare and mild, and there was no significant difference among 6 groups (P ＞0.05). The C/E ratio of group F was higher than those of other 5 groups. Conclusion The ten-day quadruple regime containing amoxicillin, doxycycline, esomeprazole and bismuth potassium citrate capsule is effective and more cost-effective for eradication of Helicobacter pylori. |
| Key words: Helicobacter pylori Amoxicillin Doxycycline Quadruple therapy |
