幽门螺杆菌应用含铋剂四联一线治疗方案根除治疗的效果观察
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摘要
目的探讨在幽门螺杆菌中应用含铋剂四联一线治疗方案根除治疗的临床效果。方法将2017年3月—2018年3月该院收治经13C呼吸试验确诊为幽门螺杆菌感染的88例慢性胃炎患者作为研究对象,将其按照治疗方案的不同随机分成观察组(n=44)与对照组(n=44),观察组患者给予埃索美拉唑、克拉霉素、阿莫西林、铋剂四联一线治疗方案根除治疗,对照组患者给予埃索美拉唑、克拉霉素、阿莫西林标准三联治疗方案根除治疗,分别对两组患者停药4周后的幽门螺杆菌根除率、服药期间的不良反应发生率进行对比分析。结果观察组患者停药4周后的幽门螺杆菌根除率95.5%明显高于对照组患者停药4周后的幽门螺杆菌根除率84.1%,差异有统计学意义(χ~2=12.638,P=0.001);观察组患者服药期间的不良反应发生率9.1%与对照组患者服药期间的不良反应发生率11.4%对比,差异无统计学意义(χ~2=1.174,P=0.612)。结论含铋剂四联一线治疗方案根除治疗幽门螺杆菌的效果要明显高于标准三联治疗方案,并且不会增加不良反应发生风险,可以作为临床一线根除幽门螺杆菌的治疗方案。
Objective To investigate the clinical effect of eradication therapy with sputumcontaining fourline firstline treatment in Helicobacter pylori. Methods From March 2017 to March 2018, 88 patients with chronic gastritis diagnosed with Helicobacter pylori infection by 13 C respiratory test were enrolled in our hospital. They were randomly divided into observation group( n=44) and the control group(n=44) according to different treatment options. The observation group was given esomeprazole, clarithromycin, amoxicillin, and expectorant quadruple treatment. The control group was given esomeprazole and clarithromycin. The amoxicillin standard triple therapy program was used to eradicate the treatment. The Helicobacter pylori eradication rate and the incidence of adverse reactions during the two weeks after drug withdrawal were compared. Results The Helicobacter pylori eradication rate of the observation group was 95.5% after 4 weeks of drug withdrawal, which was significantly higher than that of the control group after 8 weeks of drug withdrawal. The Helicobacter pylori eradication rate was 84.1% the difference wasstatistically significant( χ~2=12.638, P=0.001). the incidence of adverse reactions during the medication was 9.1% in the observation group and 11.4% in the control group, and there was no significant difference(χ~2=1.174,P=0.612). Conclusion The efficacy of the fourline firstline treatment with bismuthcontaining agent in eradicating Helicobacter pylori is significantly higher than that of the standard tripletreatment regimen, and it will not increase the risk of adverse reactions. It can be used as a treatment plan for eradication of Helicobacter pylori in the first line.
Objective To investigate the clinical effect of eradication therapy with sputumcontaining fourline firstline treatment in Helicobacter pylori. Methods From March 2017 to March 2018, 88 patients with chronic gastritis diagnosed with Helicobacter pylori infection by 13 C respiratory test were enrolled in our hospital. They were randomly divided into observation group( n=44) and the control group(n=44) according to different treatment options. The observation group was given esomeprazole, clarithromycin, amoxicillin, and expectorant quadruple treatment. The control group was given esomeprazole and clarithromycin. The amoxicillin standard triple therapy program was used to eradicate the treatment. The Helicobacter pylori eradication rate and the incidence of adverse reactions during the two weeks after drug withdrawal were compared. Results The Helicobacter pylori eradication rate of the observation group was 95.5% after 4 weeks of drug withdrawal, which was significantly higher than that of the control group after 8 weeks of drug withdrawal. The Helicobacter pylori eradication rate was 84.1% the difference wasstatistically significant( χ~2=12.638, P=0.001). the incidence of adverse reactions during the medication was 9.1% in the observation group and 11.4% in the control group, and there was no significant difference(χ~2=1.174,P=0.612). Conclusion The efficacy of the fourline firstline treatment with bismuthcontaining agent in eradicating Helicobacter pylori is significantly higher than that of the standard tripletreatment regimen, and it will not increase the risk of adverse reactions. It can be used as a treatment plan for eradication of Helicobacter pylori in the first line.
引文
[1]何小建,王雯,张志坚,等.混合疗法与含铋剂四联疗法根除幽门螺杆菌感染的疗效观察[J].胃肠病学,2017,22(3):168-171.
[2]吴光辉,郭兰洁,王菲,等.铋剂四联方案治疗幽门螺杆菌感染的临床研究[J].现代消化及介入诊疗,2017,22(6):769-771.
[3]李雨濛,马军,段芳龄.ACG临床指南:幽门螺杆菌感染的治疗[J].胃肠病学和肝病学杂志,2017,26(6):601-624.
[4]施杨利,陈耀明.含铋剂的四联用药方案治疗老年幽门螺杆菌相关性消化性溃疡的疗效分析[J].山西医药杂志,2017,46(6):682-684.
[5]徐惠明,陈小芳,周明霞,等.含铋剂的四联疗法和标准三联治疗幽门螺杆菌感染的疗效观察[J].中国血液流变学杂志,2015,25(3):300-302.
[6]邹夏慧,刘敦菊,万德惠,等.改良序贯疗法与不同四联疗法根除幽门螺杆菌的疗效分析[J].重庆医学,2016,45(17):2372-2374.
[7]梁丽娟,聂爱英,雷超,等.盐酸小檗碱、阿莫西林、兰索拉唑、铋剂四联疗法根除幽门螺杆菌283例的临床研究[J].中华消化杂志,2017,37(3):167-171.
[8]崔梅花,魏红,雷晓燕,等.含复方尿囊素四联疗法治疗幽门螺杆菌感染慢性胃炎的疗效[J].中华消化杂志,2014,34(5):297-301.
[9]齐宏.幽门螺杆菌应用含铋剂四连一线治疗方案根除治疗的效果观察[J].中国医药指南,2017,15(8):48.
[10]孔聪聪,刘改芳,吴婧,等.不同铋剂四联方案根除幽门螺杆菌240例的疗效分析[J].中华消化杂志,2014,34(8):513-515.
[11]马佑平,侯瑞瑞,张飞雄.伴同疗法与铋剂四联疗法对根除幽门螺杆菌的疗效观察[J].宁夏医科大学学报,2017,39(1):89-91.
[12]刘玉金.含铋剂四联疗法根除幽门螺杆菌感染的临床分析[J].中国医学工程,2016,24(6):88-89.
[2]吴光辉,郭兰洁,王菲,等.铋剂四联方案治疗幽门螺杆菌感染的临床研究[J].现代消化及介入诊疗,2017,22(6):769-771.
[3]李雨濛,马军,段芳龄.ACG临床指南:幽门螺杆菌感染的治疗[J].胃肠病学和肝病学杂志,2017,26(6):601-624.
[4]施杨利,陈耀明.含铋剂的四联用药方案治疗老年幽门螺杆菌相关性消化性溃疡的疗效分析[J].山西医药杂志,2017,46(6):682-684.
[5]徐惠明,陈小芳,周明霞,等.含铋剂的四联疗法和标准三联治疗幽门螺杆菌感染的疗效观察[J].中国血液流变学杂志,2015,25(3):300-302.
[6]邹夏慧,刘敦菊,万德惠,等.改良序贯疗法与不同四联疗法根除幽门螺杆菌的疗效分析[J].重庆医学,2016,45(17):2372-2374.
[7]梁丽娟,聂爱英,雷超,等.盐酸小檗碱、阿莫西林、兰索拉唑、铋剂四联疗法根除幽门螺杆菌283例的临床研究[J].中华消化杂志,2017,37(3):167-171.
[8]崔梅花,魏红,雷晓燕,等.含复方尿囊素四联疗法治疗幽门螺杆菌感染慢性胃炎的疗效[J].中华消化杂志,2014,34(5):297-301.
[9]齐宏.幽门螺杆菌应用含铋剂四连一线治疗方案根除治疗的效果观察[J].中国医药指南,2017,15(8):48.
[10]孔聪聪,刘改芳,吴婧,等.不同铋剂四联方案根除幽门螺杆菌240例的疗效分析[J].中华消化杂志,2014,34(8):513-515.
[11]马佑平,侯瑞瑞,张飞雄.伴同疗法与铋剂四联疗法对根除幽门螺杆菌的疗效观察[J].宁夏医科大学学报,2017,39(1):89-91.
[12]刘玉金.含铋剂四联疗法根除幽门螺杆菌感染的临床分析[J].中国医学工程,2016,24(6):88-89.