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[幽门螺杆菌三联疗法根除治疗的临床及微生物学疗效]

[Clinical and microbiological effectiveness of Helicobacter pylori eradication treatment with triple therapy].

作者信息

Ghandour Fawaz Yasmin, Rojo Ruiz Nagore, Díaz Núñez Javier, Sariola Molins Alba, Barreales Soto Saúl, Vilaseca Canals Jordi

机构信息

EAP Sant Josep, CAP Just Oliveras, UDMAFyC Costa Ponent Metropolitana Sud, Hospitalet de Llobregat, Barcelona, España.

EAP Sant Josep, CAP Just Oliveras, UDMAFyC Costa Ponent Metropolitana Sud, Hospitalet de Llobregat, Barcelona, España.

出版信息

Aten Primaria. 2025 Aug 1;57(12):103344. doi: 10.1016/j.aprim.2025.103344.

Abstract

OBJECTIVE

To estimate the eradication rate of Helicobacter pylori (HP) with triple therapy (amoxicillin 1g/12h, clarithromycin 500mg/12h, and omeprazole 20mg/12h/for 14 days) and to evaluate its clinical effectiveness in improving symptoms associated with HP infection. This is an observational, prospective, exposed cohort study.

DESING

Prospective observational cohort study of exposed groups.

SETTING

Urban health area with follow-up in primary care.

PARTICIPANTS

A total of 125 patients (68% women, 32% men) with untreated HP infection or who had not received eradication treatment in the last year were included, with a mean age of 52.2 years (SD ±17.5).

INTERVENTIONS

Three visits were conducted. During visit 1, informed consent was obtained, the main and secondary symptoms were recorded, and treatment was prescribed. In visit 2, after completing the treatment, adverse effects, adherence (Morisky-Green test), and clinical evolution were recorded. In visit 3, the eradication test result was verified.

MAIN MEASUREMENTS

Demographic, symptomatology, eradication, adherence, and adverse effects variables were collected.

RESULTS

The eradication rate was 92% (95% CI: 85.90-95.60%). Of these, 93.90% (95% CI: 88-97%) showed improvement or resolution of their symptoms. Therapeutic adherence was 80.80% (95% CI: 73.02-86.74%). Adverse effects appeared in 41.60% of patients, of which 35.20% were digestive-related.

CONCLUSIONS

The study supports triple therapy as a first-line option for HP infection in primary care in our setting. The majority of patients experienced a progressive improvement in their symptoms.

摘要

目的

评估三联疗法(阿莫西林1g/12小时、克拉霉素500mg/12小时和奥美拉唑20mg/12小时,疗程14天)对幽门螺杆菌(HP)的根除率,并评价其改善HP感染相关症状的临床疗效。这是一项观察性、前瞻性、暴露队列研究。

设计

对暴露组进行前瞻性观察队列研究。

地点

城市健康区域,在初级保健机构进行随访。

参与者

共纳入125例未治疗的HP感染患者或过去一年未接受根除治疗的患者(68%为女性,32%为男性),平均年龄52.2岁(标准差±17.5)。

干预措施

进行三次访视。在第1次访视时,获得知情同意,记录主要和次要症状,并开具治疗处方。在第2次访视时,完成治疗后,记录不良反应、依从性(Morisky-Green测试)和临床进展。在第3次访视时,核实根除试验结果。

主要测量指标

收集人口统计学、症状学、根除情况、依从性和不良反应变量。

结果

根除率为92%(95%置信区间:85.90 - 95.60%)。其中,93.90%(95%置信区间:88 - 97%)的患者症状有所改善或消失。治疗依从性为80.80%(95%置信区间:73.02 - 86.74%)。41.60%的患者出现不良反应,其中35.20%与消化系统有关。

结论

该研究支持三联疗法作为我们地区初级保健中HP感染的一线治疗选择。大多数患者的症状逐渐改善。

相似文献

3
Optimum duration of regimens for Helicobacter pylori eradication.幽门螺杆菌根除治疗方案的最佳疗程
Cochrane Database Syst Rev. 2013 Dec 11;2013(12):CD008337. doi: 10.1002/14651858.CD008337.pub2.

本文引用的文献

1
V Spanish Consensus Conference on Helicobacter pylori infection treatment.V 西班牙幽门螺杆菌感染治疗共识会议。
Gastroenterol Hepatol. 2022 May;45(5):392-417. doi: 10.1016/j.gastrohep.2021.07.011. Epub 2021 Oct 7.
4
Illusions regarding clinical trials and treatment guidelines.关于临床试验和治疗指南的错觉。
Gut. 2017 Dec;66(12):2043-2046. doi: 10.1136/gutjnl-2017-314744. Epub 2017 Sep 21.
8
IV Spanish Consensus Conference on Helicobacter pylori infection treatment.第四届西班牙幽门螺杆菌感染治疗共识会议
Gastroenterol Hepatol. 2016 Dec;39(10):697-721. doi: 10.1016/j.gastrohep.2016.05.003. Epub 2016 Jun 21.

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