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目的观察由雷贝拉唑、阿莫西林、克拉霉素、左氧氟沙星组成的10日序贯疗法根除幽门螺杆菌的疗效。方法将92例经电子胃镜明确的消化性溃疡和慢性胃炎伴胃黏膜萎缩或糜烂且Hp阳性成人患者随机分成两组:治疗组(46例)方案为前5 d给予雷贝拉唑10 mg和阿莫西林1000 mg,每日2次口服;后5 d给予雷贝拉唑10 mg、克拉霉素500 mg,左氧氟沙星200 mg,每日2次口服。对照组(46例)方案为标准三联疗法(雷贝拉唑10 mg,阿莫西林1000 mg,克拉霉素500 mg),每日2次,口服10 d。结果治疗组Hp根除率为93.48%(43/46),对照组为73.91%(34/46),两组比较差异有统计学意义(P<0.05)。结论由雷贝拉唑+阿莫西林+克拉霉素+左氧氟沙星组成的10日序贯疗法对成人Hp感染的根除率优于标准三联疗法,且耐受性及依从性均较好。
Objective To observe the efficacy of sequential 10-day therapy consisting of rabeprazole, amoxicillin, clarithromycin and levofloxacin in the eradication of Helicobacter pylori. Methods Ninety-two patients with definite peptic ulcer and chronic gastritis with gastric mucosal atrophy or erosion and Hp positive adults were randomly divided into two groups: the treatment group (n = 46) was given labeprazole 10 mg and Amoxicillin 1000 mg twice daily orally; Rabeprazole 10 mg, clarithromycin 500 mg, levofloxacin 200 mg twice daily orally after 5 days. The control group (n = 46) received standard triple therapy (rabeprazole 10 mg, amoxicillin 1000 mg, clarithromycin 500 mg) twice a day for 10 days. Results The eradication rate of Hp was 93.48% (43/46) in the treatment group and 73.91% (34/46) in the control group, with significant difference between the two groups (P <0.05). Conclusions 10-day sequential therapy, consisting of rabeprazole + amoxicillin + clarithromycin + levofloxacin, outperforms standard triple therapy in treating Hp infection in adults with better tolerability and compliance.