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三联疗法与序贯疗法根除幽门螺杆菌疗效的随机临床试验

Randomized Clinical Trial on the Efficacy of Triple Therapy Versus Sequential Therapy in Helicobacter pylori Eradication.

作者信息

Sharif Zain, Mubashir Muaz, Naqvi Mehdi, Atique Hassan, Mahmood Saira, Ullah Muneeb

机构信息

Gastroenterology, Nishtar Hospital Multan, Multan, PAK.

Internal Medicine, Federal Government Polyclinic Hospital, Islamabad, PAK.

出版信息

Cureus. 2022 May 10;14(5):e24897. doi: 10.7759/cureus.24897. eCollection 2022 May.

Abstract

INTRODUCTION

() colonization is prevalent all over the world, and it is associated with low socioeconomic status, poor hygiene, and overcrowding. Its eradication is important since it is an etiologic agent for gastritis, peptic ulcer, gastric carcinoma, and mucosa-associated lymphoid tissue lymphoma. Different regimens are available for the eradication of and include triple therapy and sequential therapy. Our study aims to compare the efficacy of triple therapy versus sequential therapy in the eradication of .

MATERIAL AND METHODS

This randomized clinical trial was conducted at the Pakistan Institute of Medical Sciences Hospital, Islamabad, from September 2016 to September 2017 after the approval of the institutional review board. A total of 160 patients were enrolled and equally divided into two, group A and group B. A twice-daily dose of amoxicillin 1,000 mg, rabeprazole 20 mg, and clarithromycin 500 mg was given to group A for 10 days, while group B was initially given rabeprazole 20 mg and amoxicillin 1,000 mg two times daily for the first five days (i.e., induction phase), followed by triple therapy that included rabeprazole 20 mg, clarithromycin 500 mg, and metronidazole/tinidazole 500 mg twice daily for the next five days. A negative stool antigen test performed four weeks after the completion of therapy was considered an effective eradication. A proforma was used to collect data that included age, gender, city or province of residence, family income, group (group A or group B), and eradication efficacy. Analysis of the data was performed using the Statistical Package for the Social Sciences version 17 (SPSS Inc., Chicago, USA).

RESULTS

A total of 160 patients were included, with mean age and standard deviation of 40.02±24.4 years. The male/female ratio was 1.8:1. Successful eradication of achieved in group A was 67.5% (N=54) in comparison to group B, which was 95% (N=76) (p=0.001).

CONCLUSION

Sequential therapy was superior to triple therapy in eradication.

摘要

引言

(某种细菌)定植在世界各地都很普遍,它与社会经济地位低、卫生条件差和过度拥挤有关。根除该细菌很重要,因为它是胃炎、消化性溃疡、胃癌和黏膜相关淋巴组织淋巴瘤的病原体。有不同的方案可用于根除该细菌,包括三联疗法和序贯疗法。我们的研究旨在比较三联疗法和序贯疗法在根除该细菌方面的疗效。

材料与方法

这项随机临床试验于2016年9月至2017年9月在伊斯兰堡的巴基斯坦医学科学研究所医院进行,经机构审查委员会批准。共招募了160名患者,平均分为两组,A组和B组。A组给予每日两次剂量的阿莫西林1000毫克、雷贝拉唑20毫克和克拉霉素500毫克,持续10天,而B组最初在前五天(即诱导期)给予每日两次剂量的雷贝拉唑20毫克和阿莫西林1000毫克,随后在接下来的五天给予三联疗法,包括每日两次剂量的雷贝拉唑20毫克、克拉霉素500毫克和甲硝唑/替硝唑500毫克。治疗完成四周后进行的粪便抗原阴性试验被视为根除有效。使用一份表格收集数据,包括年龄、性别、居住城市或省份、家庭收入、组别(A组或B组)和根除疗效。使用社会科学统计软件包第17版(美国芝加哥SPSS公司)对数据进行分析。

结果

共纳入160名患者,平均年龄和标准差为40.02±24.4岁。男女比例为1.8:1。A组根除该细菌的成功率为67.5%(N = 54),而B组为95%(N = 76)(p = 0.001)。

结论

在根除该细菌方面,序贯疗法优于三联疗法。

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