艾普拉唑联合铋剂10天四联方案根除幽门螺杆菌-第三军医大学学报.doc

艾普拉唑联合铋剂10天四联方案根除幽门螺杆菌临床研究 卫金歧1，丛云燕2，黄雪平2，陈美竹3，伍百贺1 （519000广东 珠海，中山大学附属第五医院：消化科1，肿瘤化疗科2，呼吸科3） [摘要] 目的 以埃索美拉唑为对照，观察艾普拉唑联合铋剂10天四联方案治疗幽门螺杆菌（helicobacter pylori，Hp）阳性慢性胃炎患者的临床疗效。方法 120例经胃镜、快速尿素酶素实验确诊的Hp阳性慢性胃炎初治患者按就诊先后完全随机分为A、B二组，分别接受埃索美拉唑或艾普拉唑 + 枸橼酸铋钾 + 阿莫西林克拉维酸钾 + 左氧氟沙星的10天四联疗法。疗程结束后4～6周内行14C尿素呼气试验检测Hp根除情况，并观察临床症状改善及不良反应发生情况。结果 ①A、B二组Hp根除率符合方案数据分析分别为81.03%（47/58)及80.77%（42/52）；意向性分析分别为78.33%（47/60）及70.00%（42/60）；②A、B二组对上腹痛、反酸、烧心等临床症状缓解有效率分别达94.83%（55/58）、94.23%(49/52)；③ A、B二组不良反应发生率分别为5.17%（3/58）、5.77%(3/52)，且轻微。经统计学分析，二组患者在上述3个方面差异均无统计学意义。结论 埃索美拉唑或艾普拉唑联合铋剂10天四联方案治疗Hp阳性慢性胃炎患者均能取得Hp根除率高、临床症状改善率高、不良反应轻的疗效。 [关键词] 埃索美拉唑；艾普拉唑；枸橼酸铋钾；幽门螺杆菌；根除 [中图法分类号] [文献标志码] A Ilaprazole based bismuth-containing 10-day quadruple regimen for the treatment of Helicobacter pylori positive chronic gastritis : a randomized,controlled clinical study Wei Jinqi1, Cong Yunyan2,Huang Xueping2, Chen Meizhu3, Wu Baihe1（1Department of Gastroenterology, 2Department of Oncology, 3Department of Pneumology, the Fifth Affiliated Hospital of Sun Yat-Sen University,Zhuhai,519000,China） [Abstract] Objective To study the clinical efficacy of 10-day quadruple regimen for the treatment of Helicobacter pylori (Hp) positive chronic gastritis and compare the eradication rate of ilaprazole versus esomeprazole-based bismuth-containing regimen. Methods A total of 120 patients with Hp-positive chronic gastritis ,who had never received Hp eradication treatment, were randomized into two groups from December 2012 to April 2013,were received esomeprazole or ilaprazole-based bismuth-containing quadruple regimen with amoxicillin and clavulanate potassium, levofloxacin for 10 days respectively(n=60 each). Eradication was confimed by a 14C-urea breath test 4-6 weeks after completion of treatment. Results The Per-protocol analysis (PP) values of Hp eradication rate were 80.77 %（42/52）and 81.03%（47/58) in groups ilaprazole and esomeprazole (P =0.56) respectively, while the Intention-to-treat