序貫療法根除初治失敗幽門螺桿菌療效觀察_《華西醫學》

作者：

黃忠 , 李智 , 侯聰

自貢市第一人民醫院（四川自貢，643000）;

關鍵詞：

序貫療法四聯療法幽門螺桿菌

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【摘要】　目的　分析總結雷貝拉唑、阿莫西林、克拉霉素、替硝唑組成的10日序貫療法根除初治失敗幽門螺桿菌（Helicobacter pylori，Hp）的療效。　方法　將2009年5月-2011年5月在消化科門診及住院經胃鏡確診的胃、十二指腸潰瘍患者65例，經標準三聯療法治療4周后Hp仍陽性的患者隨機分為兩組，治療組33例前5 d用雷貝拉唑10 mg、阿莫西林1.0，每日2次口服，后5 d用雷貝拉唑10 mg、克拉霉素500 mg、替硝唑500 mg，每日2次口服；對照組32例用雷貝拉唑10 mg、枸櫞酸鉍鉀600 mg、呋喃唑酮0.1 g、阿莫西林1.0 g，每日2次，療程10 d。停藥4周后復查Hp。　結果　治療組Hp根除率81.8%，對照組75.0%，兩組比較無統計學意義（P gt;0.05）。不良反應率分別為12.1%和34.3%，兩組比較有統計學意義（P lt;0.05）。　結論　序貫療法對初治失敗Hp根除率高于四聯療法但無統計學意義，不良反應率低于對照組，可作為根除初治失敗Hp的一種有效方案。

引用本文： 黃忠,李智,侯聰. 序貫療法根除初治失敗幽門螺桿菌療效觀察. 華西醫學, 2011, 26(10): 1539-1540. doi: 復制

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1. 　Graham DY, Shiotani A. New concepts of resistance in the treatment of Helicobacter pylori infections [J].Nat Clin Pract Gastroenterol Hepatol, 2008, 5(6): 321-331.
2. 　Zullo A, Gatta L, De Francesco V, et al. High rate of Helicobacter pylori eradication with sequential therapy in elderly patients with peptic ulcer:a prospective controlled study[J].Aliment pharmacol Ther, 2005, 21(12): 1419-1424.
3. 　Francavilla R, Lionetti E, Castellaneta SP, et al. Improved efficacy of 10-Day sequential treatment for Helicobacter pylori eradication in children:a randomized trial[J]. Gastroenterology, 2005, 129(5): 1414-1419.
4. 　Bago P, Vcer A, Tomic M, et al. High eradication rate of H.pylori with moxifloxacin-based treatment:a randomized controlled trial[J].Wien Klin Wochenschr, 2007, 119(11-12): 372-378.
5. 　De Francesco V, Margiotta M, Zullo A, et al. Clarithromycin-resistant genotypes and eradication of Helicobacter pylori[J]. Ann Inter Med, 2006, 144(2): 94-100.
6. 　De Rossi E, Aínsa JA, Riccardi G. Role of mycobacterial efflux transporters in drug resistance:an unresolved question[J]. FEMS Microbiol Rev, 2006, 30(1):36-52.
7. 　Zechini B, Versace I. Inhibitiors of multidrug resistant efflux systems in bacteria[J]. Recent Pat Antiinfect Drug Discov, 2009, 4(1): 37-50.
8. 　Lomovskaya O, Bostian KA. Practical applications and feasibility of efflux pump inhibitors in the clinic-A vision for applied use[J]. Biochen Pharmacol, 2006, 71(7): 910-918.
9. 　Hong EJ, Park DI, Oh SJ, et al. Comparison of Helicobacter pylori eradication rate in patients with non-ulcer dyspepsia and peptic ulcer diseases according to proton pump inhibitors[J].Korean J Gastroenterol, 2008, 52(2): 80-85.
10. 　Aeschlimann JR, Dresser LD, Kaatz GW, et al. Effects of NorA in-hibitors on in vitro antibacterial activities and postantibiotic effects of levofloxacin, ciprofloxacin,and norfloxacin in genetically related strains of staphylococcus aurens[J]. Antimicrob Agents Chemother, 1999, 43(2): 335-340.

《華西醫學》

序貫療法根除初治失敗幽門螺桿菌療效觀察

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《華西醫學》

序貫療法根除初治失敗幽門螺桿菌療效觀察

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