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土耳其五种不同经验性一线根除幽门螺杆菌方案的现状

Current Status of Five Different Regimens for Empiric First-Line Helicobacter pylori Eradication in Turkey.

作者信息

Gungor Gokhan, Baglıcakoglu Murat, Kayacetin Ertugrul, Biyik Murat, Ucar Ramazan, Goktepe Hakan, Ataseven Huseyin, Demir Ali

机构信息

Department of Gastroenterology, Konya Education and Research Hospital, Konya, Turkey.

出版信息

Digestion. 2015;92(2):55-9. doi: 10.1159/000434627. Epub 2015 Jul 11.


DOI:10.1159/000434627
PMID:26183105
Abstract

BACKGROUND/AIMS: This study aimed at comparing the efficacy and tolerability of 5 different regimens for Helicobacter pylori eradication in recent years. METHODS: H. pylori-positive patients with dyspeptic symptoms were included and separated into 5 groups. The 'PAC group' was given pantoprazole, amoxicillin and clarithromycin for 14 days. The 'PAM group' was given pantoprazole, amoxicillin and metronidazole for 14 days. The 'bismuth-containing group' was given pantoprazole, bismuth subsalicylate, tetracycline and metronidazole for 14 days. The 'sequential group' was given pantoprazole and amoxicillin for 5 days, followed by pantoprazole, tetracycline, and metronidazole for the next 5 days. The 'concomitant group' was given pantoprazole, amoxicillin, tetracycline, and metronidazole for 10 days. Eradication was assessed through the urea breath test on 6 weeks after eradication therapy. RESULTS: The eradication rate of intention-to-treat/per protocol were 42/48.3% in the PAC group, 52/54.2% in the PAM group, 62/77.5% in the bismuth group, 71/80.7% in the sequential group and 72/83.7% in concomitant group. The frequency of mild and moderate side effects was similar between groups. CONCLUSION: The concomitant and sequential therapies are an effective treatment for H. pylori. Bismuth-containing therapy is superior to conventional triple therapies; however, the eradication rate is not satisfactory. In our country, conventional triple therapies are not effective for eradication.

摘要

背景/目的:本研究旨在比较近年来5种不同的幽门螺杆菌根除方案的疗效和耐受性。 方法:纳入有消化不良症状的幽门螺杆菌阳性患者,并将其分为5组。“PAC组”给予泮托拉唑、阿莫西林和克拉霉素,疗程14天。“PAM组”给予泮托拉唑、阿莫西林和甲硝唑,疗程14天。“含铋剂组”给予泮托拉唑、次水杨酸铋、四环素和甲硝唑,疗程14天。“序贯组”先给予泮托拉唑和阿莫西林5天,随后给予泮托拉唑、四环素和甲硝唑5天。“联合组”给予泮托拉唑、阿莫西林、四环素和甲硝唑,疗程10天。根除治疗6周后通过尿素呼气试验评估根除情况。 结果:意向性分析/符合方案分析的根除率在PAC组为42/48.3%,PAM组为52/54.2%,铋剂组为62/77.5%,序贯组为71/80.7%,联合组为72/83.7%。各组轻度和中度副作用的发生率相似。 结论:联合疗法和序贯疗法是治疗幽门螺杆菌的有效方法。含铋剂疗法优于传统三联疗法;然而,根除率并不理想。在我国,传统三联疗法根除幽门螺杆菌无效。

相似文献

[1]
Current Status of Five Different Regimens for Empiric First-Line Helicobacter pylori Eradication in Turkey.

Digestion. 2015

[2]
Comparison of sequential and standard triple-drug regimen for Helicobacter pylori eradication: a 14-day, open-label, randomized, prospective, parallel-arm study in adult patients with nonulcer dyspepsia.

Clin Ther. 2008-3

[3]
Concomitant therapy achieved the best eradication rate for Helicobacter pylori among various treatment strategies.

World J Gastroenterol. 2015-1-7

[4]
A Randomized Controlled Trial Shows that both 14-Day Hybrid and Bismuth Quadruple Therapies Cure Most Patients with Helicobacter pylori Infection in Populations with Moderate Antibiotic Resistance.

Antimicrob Agents Chemother. 2017-10-24

[5]
A pilot study evaluating sequential administration of a PPI-amoxicillin followed by a PPI-metronidazole-tetracycline in Turkey.

Helicobacter. 2007-12

[6]
Clinical outcomes of two-week sequential and concomitant therapies for Helicobacter pylori eradication: a randomized pilot study.

Helicobacter. 2013-1-11

[7]
Comparison of bismuth-containing quadruple and concomitant therapies as a first-line treatment option for Helicobacter pylori.

Turk J Gastroenterol. 2012-2

[8]
Randomized comparison of ranitidine bismuth citrate-based triple therapies for Helicobacter pylori.

Am J Gastroenterol. 1997-12

[9]
Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial.

Lancet. 2016-10-18

[10]
Comparison of sequential therapy and amoxicillin/tetracycline containing bismuth quadruple therapy for the first-line eradication of Helicobacter pylori: a prospective, multi-center, randomized clinical trial.

BMC Gastroenterol. 2016-7-26

引用本文的文献

[1]
2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment.

Chin Med J (Engl). 2022-12-20

[2]
Evidence based guidelines for the treatment of Helicobacter pylori infection in Korea 2020.

Korean J Intern Med. 2021-7

[3]
Evidence-Based Guidelines for the Treatment of Infection in Korea 2020.

Gut Liver. 2021-3-15

[4]
Clarithromycin Versus Metronidazole in First-Line Triple Eradication Therapy Based on Resistance to Antimicrobial Agents: Meta-Analysis.

J Clin Med. 2020-2-17

[5]
Sequential versus concomitant therapy for treatment of Helicobacter pylori infection: an updated systematic review and meta-analysis.

Eur J Clin Pharmacol. 2018-1

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