含左氧氟沙星序贯疗法根除幽门螺杆菌临床观察.docVIP

含左氧氟沙星序贯疗法根除幽门螺杆菌临床观察[摘要]目的比较泮托拉唑、阿莫西林、左氧氟沙星、呋喃唑酮组成的10日序贯疗法与标准三联疗法根除幽门螺杆菌(H.pylori )的疗效和安全性。方法将我院经胃镜及病检确诊为慢性胃炎和消化性溃疡且H.pylori阳性的患者69例随机分为两组。治疗组(35例)方案：前5d，泮托拉唑40mg+阿莫西林1000mg，每日2次；后5d，泮托拉唑40mg+左氧氟沙星200 mg+呋喃唑酮100mg，每日2次。对照组(34例)方案：予标准三联疗法：泮托唑40mg+克拉霉素500mg+阿莫西林1000mg，每日2次，疗程7d。所有患者停药4周后复查14C呼气试验，判断H.pylori根除率。结果治疗组H.pylori 根除率为94.28%，6例发生轻微不良反应(17.14%)，对照组76.47%，5例发生轻微不良反应(14.71%)。两组根除率比较差异具有统计学意义(χ2＝4.97，P＜0.05)，不良方应的发生率比较无明显差异(χ2＝0.05，P＞0.05)，且未增加治疗组的经济负担。结论含左氧氟沙星的序贯疗法治疗H.pylori 感染明显优于7日标准三联疗法，是一种有效、安全、经济的可选方案。 关键词：左氧氟沙星呋喃唑酮泮托拉唑序贯疗法幽门螺杆菌 [Abstract]Objective To determine whether the sequential therapy is better than the standard triple-drug therapy in treatment of H pylori infection for adults with chronic gastritis and peptic ulcer.MethodsSixty-nine patients with H pylori positive were randomly divided two groups. Thirty five patients received a 10-day sequential therapy [Pantoprazole 40 mg， twice daily) plus amoxicillin (1000 mg， twice daily) for the first 5 days， followed by (Pantoprazole 40 mg)，Levofloxacin(200 mg) and Furazolidone (100mg) twice daily for the remaining 5 days]. Thirty-four patients received a 7-day triple therapy [Pantoprazole (40 mg)， clarithromycin (500 mg) and amoxicillin 1000 mg， twice daily]. H pylori eradication was checked four weeks after treatment using 14C-urea breath test.。ResultsThe eradication rate of the sequential therapy With levofloxacin was 94.87%，adverse reaction wer17.14%e and merely 77.50% for the control group. The difference between the two groups was significant (χ2 = 4.97， P ＜ 0.05). The two groups adverse reaction were17.14% and 14.71%. There was no difference in incidence of side effects between the two groups (χ2 = 0.05， P ＞ 0.05). The all of adverse reaction was slight. ConclusionThe Ｓequential therapy With levofloxacin achieves a higher eradication rate than the standard triple therapy for the first time in adults. It is an effective， safe and economical option for patients and possesses great potential. K