Nadir Isilay, Yonem Ozlem, Ozin Yasemin, Kilic Zeki Mesut Yalin, Sezgin Orhan
Department of Gastroenterology, Sivas Numune Hospital, and Department of Gastroenterology, Cumhuriyet University, School of Medicine, Sivas, Turkey.
South Med J. 2011 Feb;104(2):102-5. doi: 10.1097/SMJ.0b013e318200c209.
The prevalence of Helicobacter pylori (H pylori) in Turkey is high and eradication rates are low. As a result, alternative treatment strategies are required.
To evaluate the status of H pylori eradication in Turkey by comparing the results of this study to other studies reported in the literature.
Two hundred and eighty-two patients diagnosed with H pylori were included in this study. Patients were randomized into two groups. The first group consisted of 138 patients receiving 30 mg lansoprazole bid, amoxicillin 1 g bid, and clarithromycin 500 mg bid for 14 days. The second group consisted of 144 patients who received lansoprazole 30 mg bid and amoxicillin 1 g bid for seven days, followed by metronidazole 500 mg bid, tetracycline 500 mg qid, and lansoprazole 30 mg bid for an additional seven days.
H pylori eradication rates in the first group were 53.6% according to intention-to-treat analysis, and 52.5% according to per protocol analysis. In the second group, eradication rates were 72.2% per intention-to-treat analysis and 77.6% as per protocol analysis. H pylori eradication rates in the second group were significantly higher than the first group (P=0.001, P<0.05), whereas the incidence of adverse events in the second group was significantly lower (P=0.048, P<0.05).
This study found a significant difference in eradication rates between the traditional triple therapy and modified sequential therapy groups. As a result, modified sequential therapy shows promise as an alternative treatment.
土耳其幽门螺杆菌（H pylori）的感染率很高，但根除率很低。因此，需要替代治疗策略。
通过将本研究结果与文献中报道的其他研究结果进行比较，评估土耳其幽门螺杆菌的根除情况。
本研究纳入了282例被诊断为幽门螺杆菌感染的患者。患者被随机分为两组。第一组由138例患者组成，接受兰索拉唑30mg每日两次、阿莫西林1g每日两次和克拉霉素500mg每日两次，持续14天。第二组由144例患者组成，他们先接受兰索拉唑30mg每日两次和阿莫西林1g每日两次治疗7天，随后接受甲硝唑500mg每日两次、四环素500mg每日四次和兰索拉唑30mg每日两次，再持续治疗7天。
根据意向性分析，第一组幽门螺杆菌根除率为53.6%，根据符合方案分析为52.5%。在第二组中，根据意向性分析根除率为72.2%，根据符合方案分析为77.6%。第二组幽门螺杆菌根除率显著高于第一组（P = 0.001，P < 0.05），而第二组不良事件发生率显著更低（P = 0.048，P < 0.05）。
本研究发现传统三联疗法和改良序贯疗法组之间的根除率存在显著差异。因此，改良序贯疗法有望成为一种替代治疗方法。
