摘要
目的观察分阶段综合治疗难治性幽门螺杆菌感染(H.pylori)者的效果。方法共纳入2年内按共识推荐方案治疗反复失败≥3次的难治性H.pylori感染者63例,采用分阶段综合疗法治疗,即:治疗前准备(对症治疗);标准抗菌治疗(雷贝拉唑+阿莫西林+呋喃唑酮+枸橼酸铋钾)×10天;巩固治疗(双歧杆菌+荆花胃康)×14天+(双歧杆菌+枸橼酸铋钾)×14天。停药1个月复查13C呼气试验,观察H.pylori根除率;停药后及停药1个月观察主要症状缓解情况。结果 63例患者中56例成功根除H.pylori,总根除率为94.92%(56/59,PP)和88.89%(56/63,ITT)。治疗后上腹痛、腹胀、烧心、便秘等症状较治疗前明显缓解(P<0.05,P<0.01)。治疗期间未见严重不良事件。结论分阶段综合疗法能够显著提高难治性H.pylori感染的根除率。
Objective To observe the effect of 'step-by-step and synthetic therapy' in treatment of participants with refractory H.pylori infection,who had failed in consensus based treatment.Methods A total of 63 participants,with more than 3 times of eradication failure within 2 years treated by consensus recommendations,were recruited in this cohort study.They received' step-by-step and synthetic therapy' [preliminary preparation(symptomatic treatment);standard antibiotic treatment(Rabeprazole plus Amoxicillin,Furazolidone and Bismuth Potassium Citrate for 10 days);consolidation therapy(Jinghua Weikang Capsule and Bismuth Potassium Citrate for 2 weeks) plus(Bacillus bifidus and Bismuth Potassium Citrate for 2 weeks)].13 C breath test was rechecked after one month withdrawal.The eradition rate of H.pylori was observed.The relief of main symptoms were observed after withdrawal and one month after withdrawal.Results Totally 56 of 63 cases got negative conversion of H.pylori.Per protocol(PP) was 94.92%(56/59) and intention to treat(ITT) was 88.89%(56/63).Digestive symptoms,such as epigastric pain,bloating,heartburn,and constipation were obviously relieved after treatment(P<0.05,P<0.01).No serious adverse event occurred during the treatment course.Conclusion This new strategy(step-by-step and synthetic therapy) could significantly improve the eradication rate of refractory H.pylori infection.
引文
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