艾普拉唑、左氧氟沙星和克拉霉素三联疗法根除幽门螺杆菌的临床研究

目的]比较艾普拉唑、左氧氟沙星和克拉霉素三联疗法和标准三联疗法根除治疗幽门螺杆菌(Helicobacter pylori,Hp)的临床疗效。方法]将120例Hp阳性患者随机分为治疗组与对照组。治疗组60例给予艾普拉肠溶片5mg、2次/d,左氧氟沙星0.5g、1次/d,克拉霉素500mg、2次/d;对照组60例给予奥美拉唑肠溶片20mg、阿莫西林1g、克拉霉素500mg,均为2次/d;2组疗程均为7d。疗程结束后4周复查Hp。结果]意向治疗分析:治疗组根除率为86.7%,对照组为73.3%,差异有统计学意义(P=0.037);按符合方案集分析:治疗组根除率为91.4%,对照组为77.2%,差异有统计学意义(P=0.036)。治疗组不良反应率为6.7%,对照组为8.3%,无显著差异。结论]艾普拉唑、左氧氟沙星和克拉霉素三联疗法能有效根除Hp,且不良反应较少,是未来根除Hp有希望的一线疗法。

Triple therapy with ilaprazole,ievofloxacin and clarithromycin for the eradication of Helicobacter pylori

Objective]To evaluate the efficacy of triple therapy with ilaprazole, levofloxacin and clar- ithromycin and standard triple therapy for Helicobacter pylori （Hp）eradication. Methods]One hundred and twenty Hp（＋）patients were randomized to two groups：the treatment group：60 patients received ila- prazole 5 mg, bid, levofloxacin 0. 5 g, qd, and clarithromycin 500 rag, bid, for 7 days~ 60 patients received omeprazole 20 mg,bid,amoxicillin 1 g, bid, and clarithromycin 500 rag, bid, for 7 days. Follow-up Hp test was performed at four weeks after the treatment. Results]Intention-to-treat analysis showed that the erad- ication rate of the ilaprazole group was significantly higher that of the control group（86.7 % vs 73.3 %, P= 0. 037）. Per-protocol analysis reached similar results （91.4% vs 77. 2~, P = 0. 036）. The rate of adverse effect was not different between the two groups（6. 7% vs 8. 3%）. Conclusion]The triple therapy with ila- prazole, levofloxacin and clarithromycin is an effective regimen for Hp eradication with few adverse effects, and may be a first line therapy for Hp eradication in the future.