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标准三联疗法、序贯疗法及基于莫西沙星的三联疗法治疗幽门螺杆菌感染的比较:患者依从性及细菌根除率

Comparison of standard triple therapy, sequential therapy and moxifloxacin-based triple therapy for Helicobacter pylori infection: Patients' compliance and bacterial eradication rates.

作者信息

Rakici Halil, Akdoğan Remzi Adnan, Bedir Recep, Copur Aysegul, Yilmaz Arif

机构信息

Department of Gastroenterology, Recep Tayyip Erdogan University, Rize, Turkey.

出版信息

J Dig Dis. 2014 Sep;15(9):508-13. doi: 10.1111/1751-2980.12171.

Abstract

OBJECTIVE

To compare the patients' compliance with and the efficacy of existing treatments for Helicobacter pylori eradication, including moxifloxacin-based triple therapy, sequential treatment and the standard treatment.

METHODS

Patients with H. pylori infection were randomly assigned to three therapy groups. The triple therapy (MML) group was given moxifloxacin 400 mg/day, metronidazole 500 mg b.i.d. and lansoprazole 30 mg b.i.d. for 10 days. The sequential treatment (AL-CML) group was administrated amoxicillin 1 g b.i.d. and lansoprazole 30 mg b.i.d. for the first 5 days, followed by clarithromycin 500 mg b.i.d., metronidazole 500 mg b.i.d. and lansoprazole 30 mg b.i.d. for the second 5 days. The standard treatment (CAL) group received amoxicillin 1 g b.i.d., clarithromycin 500 mg b.i.d. and lansoprazole 30 mg b.i.d. for 14 days. The eradication rates were evaluated by per-protocol (PP) analysis and intention-to-treat (ITT) analysis.

RESULTS

The eradication rates were 87.1, 85.9 and 85.2% by PP analysis and 87.1, 84.9 and 84.2% by ITT analysis in the MML, AL-CML and CAL group, respectively, and patients' compliance rates were 98.2, 96.5 and 97.1%, respectively. There were no significant differences in treatment efficacy and compliance rates in the MML, AL-CML and CAL groups (P > 0.05).

CONCLUSIONS

The present study revealed that standard triple therapy, sequential therapy and moxifloxacin-based triple therapy are all effective treatment regimens in terms of H. pylori eradication rates and compliance with therapy in Turkey.

摘要

目的

比较患者对现有幽门螺杆菌根除治疗方案的依从性及疗效,包括基于莫西沙星的三联疗法、序贯疗法和标准疗法。

方法

将幽门螺杆菌感染患者随机分为三个治疗组。三联疗法(MML)组给予莫西沙星400毫克/天、甲硝唑500毫克每日两次、兰索拉唑30毫克每日两次,疗程10天。序贯疗法(AL-CML)组在前5天给予阿莫西林1克每日两次和兰索拉唑30毫克每日两次,随后在接下来的5天给予克拉霉素500毫克每日两次、甲硝唑500毫克每日两次和兰索拉唑30毫克每日两次。标准疗法(CAL)组给予阿莫西林1克每日两次、克拉霉素500毫克每日两次和兰索拉唑30毫克每日两次,疗程14天。通过符合方案(PP)分析和意向性治疗(ITT)分析评估根除率。

结果

MML组、AL-CML组和CAL组通过PP分析的根除率分别为87.1%、85.9%和85.2%,通过ITT分析的根除率分别为87.1%、84.9%和84.2%,患者的依从率分别为98.2%、96.5%和97.1%。MML组、AL-CML组和CAL组在治疗疗效和依从率方面无显著差异(P>0.05)。

结论

本研究表明,在土耳其,就幽门螺杆菌根除率和治疗依从性而言,标准三联疗法、序贯疗法和基于莫西沙星的三联疗法都是有效的治疗方案。

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