摘要
目的比较在三联疗法基础上分别联用布拉氏酵母菌散和铋剂对慢性胃炎及十二指肠溃疡患者幽门螺杆菌(Hp)感染的根除效果及安全性。方法伴有Hp感染的慢性胃炎或十二指肠溃疡患者176例,其中慢性胃炎116例,十二指肠溃疡60例。慢性胃炎患者采用分段随机法分为对照组和治疗组,各58例。治疗组在以雷贝拉唑+阿莫西林+左氧氟沙星三联疗法基础上,加服布拉氏酵母菌散500 mg,bid,与抗菌药物间隔3 h;对照组在三联疗法基础上加服胶体果胶铋胶囊150 mg,bid,两组疗程均为14 d。十二指肠溃疡患者作为溃疡组,给予加服胶体果胶铋胶囊的四联疗法后,继续服用雷贝拉唑14 d。患者均在停药4周后进行13C尿素呼气试验检测Hp。结果完成观察者170例。意向性治疗(ITT)分析:慢性胃炎患者Hp总根除率为86.2%,治疗组和对照组分别为84.5%,87.9%;溃疡组患者Hp根除率为90.0%。符合方案集(PP)分析:慢性胃炎患者Hp总根除率为90.9%,治疗组和对照组分别为87.5%,94.4%。3组Hp根除率差异无统计学意义(P>0.05)。治疗组、对照组和溃疡组不良反应发生率分别为10.3%,20.7%,21.7%(P<0.05)。结论含布拉氏酵母菌散的四联疗法可有效根除Hp,且能减少不良反应发生。
Objective To compare the efficacy and safety of Saccharomyces boulardii sachets and bismuth in the treatment of chronic gastritis and duodenal ulcer patients with Helicobacter pylori( Hp) infection. Methods A total of 176 patients with chronic gastritis or duodenal ulcer with Hp infection were enrolled. Patients with chronic gastritis( n = 116) were randomly divided into the treatment group( 58 cases) and the control group( 58 cases) : treatment group received triple therapy( rabeprazole+amoxicillin +levofloxacin) and Saccharomyces boulardii sachets for 14 days; control group received triple therapy and colloidal bismuth pectin for 14 days. Patients with duodenal ulcer( n = 60) were ulcer group,given with bismuth-containing quadruple therapy for 14 days,then rabeprazole for 14 days. All patients were tested for13 C urea breath test four weeks after stopping treatment. Results One hundred and seventy cases completed the trial. Hp eradication rate was 84.5% in treatment group,87.9% in control group,and 90.0% in ulcer group( analysis by intent of treatment,ITT analysis).The difference between the three groups was not statistically significant( P > 0. 05). The incidence of adverse events was significantly lower in treatment group( 10.3%) than in control group( 20. 7%) and ulcer group( 21. 7%)( P < 0. 05). Conclusion Quadruple therapy with Saccharomyces boulardii sachets can effectively eradicate Hp. It can reduce the occurrence of adverse reactions.
出处
《医药导报》
CAS
2017年第9期990-992,共3页
Herald of Medicine
关键词
布拉氏酵母菌散
铋剂
三联疗法
幽门螺杆菌
Saccharomyces boulardii sachets
Bismuth agent
Triple therapy
Helicobacter pylori
