Masjedizadeh Abdol Rahim, Hajiani Eskandar, Jalal Hashemi Seyed, Alavinejad Pezhman, Dalvand Hasan
Division of Gastroenterology and Hepatology, Department of Internal Medicine; Research Center for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Research Center for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Euroasian J Hepatogastroenterol. 2014 Jul-Dec;4(2):63-66. doi: 10.5005/jp-journals-10018-1103. Epub 2014 Jul 28.
To compare the efficacy of quadruple and sequential therapy in eradication of in a randomized study.
Three hundred positive patients were enrolled into the study. These patients were randomly divided into two groups: group I (n = 150) received quadruple therapy (20 mg omeprazole bid, 240 mg bismuth subcitrate bid, 1,000 mg tetracycline bid and 500 mg metronidazole bid) for 14 days, group II (n = 150) received sequential therapy (20 mg omeprazole bid, 1,000 mg amoxicillin bid for 5 days, followed by 20 mg omeprazole bid, 500 mg metronidazole bid, 500 mg clarithromycin for the other 5 days). status was assessed by histology and rapid urease test at baseline. Follow-up breath test by 14C urea breath test (UBT) was performed 4 weeks after completion of treatment. Eradication was defined as negative results on UBT.
Successful eradication was achieved in 245 patients. In each group, five patients did not tolerate the regimen and were excluded from analysis. About 29 (20%) patients who received sequential therapy and 21 (14.5%) of the quadruple group tolerated mild side effects (p = 0.21).Per-protocol analysis demonstrated eradication rates of 86.9% for sequential therapy and 82.7% for quadruple therapy (p = 0.26). Results according to the intention to treat analysis were 84 and 79.5% in the sequential and quadruple group respectively. Eradication rate differences were not significant.
The success rate of sequential therapy is comparable with quadruple therapy. Sequential therapy due to the short duration and lesser drug usage is a good alternative for eradication of in the country. Masjedizadeh AR, Hajiani E, Hashemi SJ, Alavinejad P, Dalvand H. Sequential Therapy Quadruple Therapy for Eradication in South West of Iran. Euroasian J Hepato-Gastroenterol 2014;4(2):63-66.
在一项随机研究中比较四联疗法和序贯疗法根除幽门螺杆菌的疗效。
300例幽门螺杆菌阳性患者纳入本研究。这些患者被随机分为两组：第一组（n = 150）接受四联疗法（奥美拉唑20毫克，每日两次；枸橼酸铋钾240毫克，每日两次；四环素1000毫克，每日两次；甲硝唑500毫克，每日两次），疗程14天；第二组（n = 150）接受序贯疗法（奥美拉唑20毫克，每日两次；阿莫西林1000毫克，每日两次，共5天，随后奥美拉唑20毫克，每日两次；甲硝唑500毫克，每日两次；克拉霉素500毫克，再治疗5天）。在基线时通过组织学和快速尿素酶试验评估幽门螺杆菌感染状况。治疗结束4周后通过¹⁴C尿素呼气试验（UBT）进行随访呼气试验。根除定义为UBT结果阴性。
245例患者成功根除幽门螺杆菌。每组中有5例患者不耐受该方案，被排除在分析之外。接受序贯疗法的患者中约29例（20%）和四联疗法组的21例（14.5%）耐受轻微副作用（p = 0.21）。符合方案分析显示序贯疗法的根除率为86.9%，四联疗法为82.7%（p = 0.26）。根据意向性分析结果，序贯组和四联组分别为84%和79.5%。根除率差异无统计学意义。
序贯疗法的成功率与四联疗法相当。由于疗程短且用药较少，序贯疗法是该国根除幽门螺杆菌的一种良好替代方案。马斯杰迪扎德AR、哈吉亚尼E、哈希米SJ、阿拉维内贾德P、达尔万德H。伊朗西南部根除幽门螺杆菌的序贯疗法与四联疗法。《欧亚肝脏胃肠病学杂志》2014年；4（2）：63 - 66。
