Liu Ting-Wen, Chen Yen-Po, Ho Cheng-Yu, Chen Ming-Jen, Wang Horng-Yuan, Shih Shou-Chuan, Liou Tai-Cherng
Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan.
Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan.
Biomedicines. 2023 Apr 3;11(4):1084. doi: 10.3390/biomedicines11041084.
can be eradicated immediately via local application of single-dose medicament on endoscopic examination. In our previous report, "the eradication rate of intraluminal therapy for infection (ILTHPI) is 53.7% (51/95) using medicament containing amoxicillin, metronidazole, and clarithromycin". We aimed to evaluate the efficacy and adverse events of medicament containing tetracycline, metronidazole, and bismuth and to improve the efficacy of stomach acid control before ILTHPI. After usage of dexlansoprazole (60 mg b.i.d.) or vonoprazan (20 mg q.d.) for 3 days before ILTHPI, 103 of 104 (99.1%) symptomatic -infected treatment-naïve patients achieved levels of stomach pH ≥ 6. Patients were randomized to receive ILTHPI with medicaments containing tetracycline, metronidazole, and bismuth (Group A, = 52) or amoxicillin, metronidazole, and clarithromycin (Group B, = 52). The eradication rate of ILTHPI was similar between Group A (76.5%; 39/51) and Group B (84.6%, 44/52) ( = 0.427) and the adverse event was mild diarrhea (2.9%; 3/104). The eradication rate significantly increased from 53.7% (51/95) to 84.6% (44/52) after acid control ( = 0.0004) for Group B patients. The overall eradication rates of successful ILTHPI plus 7-day non-bismuth (Group A) or 7-day bismuth (Group B) oral quadruple therapy for ILTHPI failure patients were both excellent (96.1% for Group A and 98.1% for Group B).
在内镜检查时通过局部应用单剂量药物可立即根除。在我们之前的报告中，“使用含阿莫西林、甲硝唑和克拉霉素的药物进行腔内治疗幽门螺杆菌感染（ILTHPI）的根除率为53.7%（51/95）”。我们旨在评估含四环素、甲硝唑和铋剂的药物的疗效及不良事件，并在ILTHPI之前提高胃酸控制的效果。在ILTHPI前3天使用右兰索拉唑（60毫克，每日两次）或沃克（20毫克，每日一次）后，104例有症状的初治感染患者中有103例（99.1%）胃pH值≥6。患者被随机分为接受含四环素、甲硝唑和铋剂的ILTHPI治疗组（A组，n = 52）或含阿莫西林、甲硝唑和克拉霉素的治疗组（B组，n = 52）。A组（76.5%；39/51）和B组（84.6%，44/52）的ILTHPI根除率相似（P = 0.427），不良事件为轻度腹泻（2.9%；3/104）。B组患者在进行胃酸控制后，根除率从53.7%（51/95）显著提高至84.6%（44/52）（P = 0.0004）。对于ILTHPI治疗失败的患者，成功的ILTHPI联合7天非铋剂（A组）或7天铋剂（B组）口服四联疗法的总体根除率均极佳（A组为96.1%，B组为98.1%）。
