对幽门螺杆菌根除失败后补救治疗方案的临床研究

目的分析幽门螺杆菌(Hp)标准化治疗失败后两种补救治疗方案的有效性。方法招募2009年9月至2011年6月门诊诊断Hp阳性患者526例,进行奥美拉唑联合阿莫西林及克拉霉素标准方案治疗,将治疗失败患者随机分成两组,分别进行奥美拉唑联合阿莫西林及左氧氟沙星、奥美拉唑联合阿莫西林及替硝唑进行补救治疗,观察并比较两组间治疗效果及不良反应的差异。结果 526例首次根除治疗失败率18.44%,奥美拉唑联合阿莫西林及左氧氟沙星补救治疗组有效率91.11%,奥美拉唑联合阿莫西林及替硝唑补救治疗组有效率74.47%,两组间有效率差异有统计学意义(P=0.02),不良反应率差异无统计学意义(P=0.18)。结论两种方案在Hp补救治疗中均显示有效,但是奥美拉唑联合阿莫西林及左氧氟沙星方案相比更加有效。

Clinical randomized control trail on rescue regimens for helicobacter pylori-positive patients treated failure by a first-line eradication regimen

Objective To study on the effectiveness of rescue treatment for helicobacter pylori after the failure therapy of a first-line eradication regimen.Methods Five hundred and twenty-six cases infected with helicobacter pylori were treated by using omeprazole combined with clarithromycin and amoxicillin in outpatient department from September 2009 to June 2011.The treated failure patients were randomly divided into two groups.Group OAL was treated by using omeprazole combined with amoxicillin and levofloxacin,group OAT was treated by using omeprazole combined with amoxicillin and tinidazole.Then,the effectiveness and side effect of therapy were observed.Results The failure rate of standard treatment was 18.44%,and the effective rate of group OAL and group OAT was 91.11% and 74.47% respectively.The difference in efficiency between the two groups was significant statistically(P=0.02).The difference of adverse events between the groups was not significant statistically(P=0.18).Conclusions The two rescue regimens are effective rescue therapies for helicobacter pylori,the regimen of omeprazole combined with amoxicillin and levofloxacin is more effective.