Gungor Gokhan, Baglıcakoglu Murat, Kayacetin Ertugrul, Biyik Murat, Ucar Ramazan, Goktepe Hakan, Ataseven Huseyin, Demir Ali
Department of Gastroenterology, Konya Education and Research Hospital, Konya, Turkey.
Digestion. 2015;92(2):55-9. doi: 10.1159/000434627. Epub 2015 Jul 11.
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.
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。
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