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目的探讨不同疗程标准三联疗法复合布拉酵母菌对根除幽门螺杆菌(Helicobacter pylori,H.pylori)疗效的影响及其对治疗中不良反应的改善情况进行系统评价。方法 H.pylori阳性的慢性胃炎、消化性溃疡患者240例,随机分为对照组、短疗程组、中疗程组、长疗程组,每组60例。对照组给予克拉霉素、阿莫西林、潘托拉唑三联治疗14 d,短疗程组、中疗程组、长疗程组在上述标准三联、14 d疗法开始治疗的同时分别加用布拉酵母菌,分别服用2、3、4周,在完成根除H.pylori治疗后第5周进行14C-UBT复查,比较各组H.pylori根除率、药物不良反应发生率,试验结果阴性患者在治疗结束后第3、6、9、12个月复查14C-尿素呼气试验。结果 213按试验设计完成治疗,194例患者按试验设计完成随访。短疗程组H.pylori根除率(73.5%)与对照组(65.9%)比较差异无统计学意义(P>0.05),中疗程组(91.4%)、长疗程组(93.1%)根除率均高于对照组,差异有统计学意义(P<0.05),中疗程组根除率略低于长疗程组,但差异无统计学意义。各疗程组不良反应发生率均较对照组显著降低(P<0.05),但组间比较差异无统计学意义;4组方案中以中等剂量成本-效果比最低(6.56),对照组最高(7.59);各疗程组累积复发率均低于对照组低(P<0.05,P<0.01,P<0.01),各疗程组累积复发率比较差异无统计学意义。结论联用布拉酵母菌能显著提高H.pylori根除率,降低其不良反应,3周疗程为最佳选择治疗周期。数字与后文不符。
Objective To investigate the effects of different course standard triple therapy, Saccharomyces boulardii, on the eradication of Helicobacter pylori (H.pylori) and the improvement of adverse reactions in the treatment. Methods A total of 240 patients with chronic gastritis and peptic ulcer were randomly divided into control group, short-course group, middle-course group and long-course group with 60 cases in each group. The control group was given clarithromycin, amoxicillin and pantoprazole triple therapy for 14 days. The short-course group, medium-course group and long-course group were treated with the above standard triple therapy and the 14-day therapy. , Taking 2, 3, and 4 weeks respectively. The 14C-UBT was performed in the fifth week after the eradication of H.pylori. The eradication rate of H.pylori and the incidence of adverse drug reactions in each group were compared. After the treatment, 3,6,9,12 months review 14C-urea breath test. Results 213 completed the treatment according to the experimental design, and 194 patients were followed up according to the experimental design. The eradication rate of H.pylori (73.5%) in the short course group was not significantly different from that in the control group (65.9%) (P> 0.05). The eradication rate of middle course group (91.4%) and long course group (93.1% In the control group, the difference was statistically significant (P <0.05). The middle-stage treatment group’s eradication rate was slightly lower than the long-term treatment group, but the difference was not statistically significant. The incidence of adverse reactions in each course of treatment was significantly lower than that of the control group (P <0.05), but there was no significant difference between the two groups. Among the four groups, the median cost-effect ratio was the lowest (6.56) ). The cumulative recurrence rate of each course group was lower than that of the control group (P <0.05, P <0.01, P <0.01). There was no significant difference in the cumulative recurrence rate between the groups. Conclusion Saccharomyces boulardii can significantly improve the eradication rate of H.pylori and reduce its adverse reactions, and the 3-week course of treatment is the best choice treatment period. The figures do not match what follows.