Chuah Yoen-Young, Wu Deng-Chyang, Chuah Seng-Kee, Yang Jyh-Chin, Lee Tzong-Hsi, Yeh Hong-Zen, Chen Chan-Lin, Liu Yu-Hwa, Hsu Ping-I
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital and National Yang-Ming University, Kaohsiung, Taiwan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ping-Tung Christian Hospital, Ping-Tung county, Taiwan.
Helicobacter. 2017 Jun;22(3). doi: 10.1111/hel.12380. Epub 2017 Feb 28.
The aims of the study were: 1, to survey the most popular anti-H. pylori regimens in Asia-Pacific region and the real-world effectiveness of these regimens; and 2, to investigate the expectation gaps of eradication rate between physicians and patients.
A questionnaire was distributed to Asia-Pacific physicians who attended the Asia-Pacific Digestive Week 2015 meeting. Reported eradication rates from the literatures were compared with real-world rates of surveyed popular regimens within the region. In addition, a questionnaire was distributed to H. pylori-infected patients in three regions of Taiwan.
A total of 691 physicians and 539 patients participated in the survey. The top five most commonly used regimens were 7-day clarithromycin-based standard triple therapy (50.4%), 14-day clarithromycin-based standard triple therapy (31.0%), 10-day sequential therapy (6.1%), 14-day bismuth quadruple therapy (3.9%), and 14-day hybrid therapy (3.6%). All countries except for China had a significant gap between the expectation of physicians on anti-H. pylori therapy and the real-world eradication rate of most commonly adopted regimens (all P value <.05). The expectation on minimal eradication rate among patients was higher than that of physicians (91.4% vs 86.5%, P<.001).
It is time for physicians in Asia-Pacific countries to adopt newer and more efficacious anti-H. pylori regimens to meet the Kyoto consensus recommendation and their patients' expectations.
本研究的目的为:1. 调查亚太地区最常用的抗幽门螺杆菌治疗方案及其在现实世界中的有效性;2. 调查医生与患者在根除率方面的期望差距。
向参加2015年亚太消化周会议的亚太地区医生发放问卷。将文献报道的根除率与该地区调查的常用治疗方案的实际根除率进行比较。此外,还向台湾三个地区的幽门螺杆菌感染患者发放了问卷。
共有691名医生和539名患者参与了调查。最常用的五种治疗方案分别为:7天克拉霉素标准三联疗法(50.4%)、14天克拉霉素标准三联疗法(31.0%)、10天序贯疗法(6.1%)、14天铋剂四联疗法(3.9%)和14天混合疗法(3.6%)。除中国外,所有国家医生对抗幽门螺杆菌治疗的期望与最常用治疗方案的实际根除率之间均存在显著差距(所有P值<0.05)。患者对最低根除率的期望高于医生(91.4%对86.5%,P<0.001)。
亚太国家的医生应采用更新、更有效的抗幽门螺杆菌治疗方案,以符合京都共识推荐并满足患者的期望。