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目的评价两种幽门螺杆菌(Helicobacter pylori,H.pylori)补救治疗方案的的疗效和安全性。方法选择我院消化内科规范根除H.pylori,三联方案治疗失败病例163例,随机分为四联方案组(奥美拉唑20 mg+阿莫西林1.0 g+替硝唑500 mg+胶体果胶铋200 mg)和序贯方案组(先奥美拉唑20 mg+阿莫西林1.0 g,后奥美拉唑20 mg+痢特灵0.1 g+克拉霉素500 mg),治疗结束至少4周后通过13C-尿素呼吸试验判断根除效果,评价安全性。结果四联方案组78例,H.pylori根除69例,根除率88.5%,不良反应发生率为14.1%(11例);序贯方案组85例,H.pylori根除70例,根除率82.3%,不良反应发生率为32.9%(28例),两组根除率比较无显著差异,但四联方案组不良反应发生率低于序贯方案组,且有统计学意义(P<0.05)。结论四联方案及序贯方案均能有效根除H.pylori,序贯方案不良反应发生率相对较高。
Objective To evaluate the efficacy and safety of two Helicobacter pylori remedies. Methods A total of 163 cases of failure of triple therapy were randomly divided into four groups (omeprazole 20 mg + amoxicillin 1.0 g + tinidazole 500 mg + colloidal bismuth pectin 200 mg ) And sequential regimen groups (first 20 mg omeprazole + 1.0 g amoxicillin, 20 mg omeprazole + 0.1 g clafriocide 500 mg clarithromycin) and respiration through 13 C-urea after at least 4 weeks of treatment Test to determine the eradication effect, evaluate the safety. Results In the quadruple protocol group, 78 cases were eradicated by H.pylori, the eradication rate was 88.5%, and the incidence of adverse reactions was 14.1% (11 cases). In the sequential therapy group, 85 cases were eradicated with H.pylori 70 cases and the eradication rate was 82.3% , And the incidence of adverse reactions was 32.9% (28 cases). There was no significant difference between the two groups in the eradication rate, but the incidence of adverse reactions in the quadruple protocol group was lower than that in the sequential protocol group (P <0.05). Conclusions Both quadruple and sequential protocols can effectively eradicate H.pylori, and the incidence of adverse reactions in sequential regimens is relatively high.