不同疗程雷贝拉唑四联疗法根除幽门螺杆菌的效果观察

·短篇论著·不同抗生素组合的含铋剂四联方案根除幽门螺杆菌的疗效分析齐 涛 钱丹烨 朱黎明【摘要】 目的 比较不同抗生素组合的含铋四联疗法的疗效，为优化根除幽门螺杆菌（Hp ）经验性治疗方案提供参考。

方法 回顾性分析2015年1月至2020年12月期间符合纳入标准的962例上海交通大学医学院附属第九人民医院门诊患者的根除Hp 治疗方案，在雷贝拉唑联合铋剂的基础上，根据抗生素组合的不同分为A 组（阿莫西林＋克拉霉素）、B 组（阿莫西林＋左氧氟沙星）、C 组（克拉霉素＋ 甲硝唑）和D 组（克拉霉素＋左氧氟沙星），所有方案的疗程均为14 d ，患者停药至少4周后行13C 尿素呼气试验，判断根除Hp 是否成功。

结果 基于意向治疗（ITT ）分析，A 组、B 组、C 组和D 组的Hp 根除率分别为79.37%、77.05%、59.65%和62.81%；基于符合方案集（PP ）分析，A 组、B 组、C 组和D 组的Hp 根除率分别为84.75%、80.57%、63.91%和68.78%；A 组和B 组的Hp 根除率分别高于C 组和D 组，差异均有统计学意义（P 均＜0.01）；A 组的Hp 根除率高于B 组，但差异无统计学意义（P ＞0.05）。

结论 在上海宝山地区行根除Hp 治疗应首选阿莫西林联合克拉霉素的铋剂四联方案；阿莫西林联合左氧氟沙星的铋剂四联方案的Hp 根除率较高，可用于补救治疗；克拉霉素联合左氧氟沙星的铋剂四联方案可作为青霉素过敏患者的备选方案之一；不宜选用克拉霉素联合甲硝唑的铋剂四联方案作为一线疗法。

【关键词】 四联疗法；幽门螺杆菌；疗效分析DOI: 10. 3969/j. issn. 1673-534X. 2022. 03. 014作者单位：201999 上海交通大学医学院附属第九人民医院消化科通信作者：幽门螺杆菌（Hp ）是一种呈螺旋形或弧形弯曲状的微需氧格兰氏阴性杆菌，可引起多种消化道疾病，如慢性胃炎、消化性溃疡、胃MALT 淋巴瘤，甚至胃癌[1-2]。

雷贝拉唑四联疗法治疗幽门螺杆菌阳性消化性溃疡的价值【摘要】目的：讨论雷贝拉唑四联疗法治疗幽门螺杆菌阳性消化性溃疡的价值。

方法：选取我院2021年12月到2022年12月收治的120例幽门螺杆菌阳性胃溃疡患者进行研究，均分为观察组和对照组，60例行奥美拉唑四联疗法治疗的患者为对照组，剩余患者接受雷贝拉唑四联疗法，为观察组。

结果：观察组临床有效率为98.33%，较对照组的70.00%更高；不良反应率仅为6.67%，较对照组的20.00%更低；溃疡愈合、Hp根除时间、上腹疼痛、腹胀、嗳气消失时间更短；Hp根除率高达93.33%，且复发率较对照组的21.67%更低，2组相比，差异具有统计学意义（P<0.05）。

结论：雷贝拉唑四联疗法可使患者腹胀、腹痛等症状得到有效改善，促使溃疡病灶尽快愈合，值得广为运用。

关键词：幽门螺杆菌阳性胃溃疡；雷贝拉唑；四联疗法；价值【 abstract 】 objective to discuss the value of rabeprazole quadruple therapy in the treatment of Helicobacter pylori peptic ulcer. Methods: a total of 120 patients with 2021 gastric ulcer admitted toour hospital from December 2021 to December 2022 were Helicobacterpylori into observation group and control group, the control group was treated with omeprazole and the other patients were treated with rabeprazole. Results: the clinical effective rate of the observation group was 98.33% , which was higher than that of the control group (70.00%) , and the adverse reaction rate was only 6.67% , which was lower than that of the control group (20.00%) The time of ulcer healing, HP eradication, epigastric pain, abdominal distention and belching was shorter, the HP eradication rate was 93.33% , and the recurrence rate was lower than that of the control group (21.67%) ,the difference was statistically significant (p< 0.05) . Conclusion: The rabeprazole therapy can effectively improve the symptoms of abdominal distension and pain, and promote the ulcer focus to heal as soon as possible.Keywords: Helicobacter pylori gastric ulcer; rabeprazole;quadruple therapy; value消化性溃疡属于消化内科常见且多发病症，病灶主要在胃及十二指肠等处，酸性胃液及蛋白酶对黏膜的消化是诱发该病的最基本原因[1]。

雷贝拉唑、克拉霉素、阿莫西林、胶体铋剂四联治疗幽门螺杆菌感染慢性胃炎的疗效探讨【摘要】目的探讨雷贝拉唑、克拉霉素、阿莫西林、胶体铋剂四联疗法在幽门螺杆菌安然慢性胃炎中的治疗效果。

方法收集2014 年5 月至2015 年5 月我中心收治的幽门螺杆菌感染慢性胃炎患者50 例，采用随机数字法分为两组，对照组（n=25）使用雷贝拉唑、克拉霉素、胶体铋剂三联疗法进行治疗，观察组（n=25）使用雷贝拉唑、克拉霉素、阿莫西林、胶体铋剂四联疗法进行治疗，比较两组患者的治疗效果和幽门螺杆菌（Hp）清除率和不良反应发生率。

结果观察组患者治疗有效率和HP清除率均明显优于对照组，P<0.05；两组患者不良反应发生率无显著性差异，P>0.05。

结论雷贝拉唑、克拉霉素、阿莫西林、胶体铋剂四联疗法可有效提高幽门螺杆菌感染慢性胃炎患者的治疗效果，对于改善患者的症状、提高Hp清除率均具有积极作用，且治疗过程中患者不良反应较少，安全性良好，值得推广应用。

【关键词】雷贝拉唑；克拉霉素；阿莫西林；胶体铋剂；幽门螺杆菌；慢性胃炎【Abstract 】 objective to explore the rabeprazole azole，clarithromycin，amoxicillin，colloidal bismuth agent quadruple therapy in the treatment of helicobacter pylori in chronic gastritis. Method collected in May 2014 to May 2015，the center of helicobacter pylori infection in 50 cases of patients with chronic gastritis，can be divided into two groups by random number method，the control group（n = 25）using rabeprazole azole，clarithromycin，colloidal bismuth triple therapy treatment，observation group（n = 25）using rabeprazole azole，clarithromycin，amoxicillin，colloidal bismuth agent quadruple therapy treatment，compare the curative effect of two groupsof patients and helicobacter pylori（Hp）clearance rate and incidence of adverse reactions. Results the observation group of patients treatment efficient and HP clearance were significantly better than the control group，P < 0.05；Two groups of patients with adverse reactions was no significant difference，P > 0.05）. Conclusion rabeprazole azole，clarithromycin，amoxicillin，colloidal bismuth agent quadruple therapy can effectively improve the therapeutic effect of helicobacter pylori infection in chronic gastritis patients，to improve the patient's symptoms，improve Hp clearance all has the positive role，and the treatment of patients with less adverse reaction in the process，the security is good，is worth popularization and application.【Key words 】 rabeprazole thiazole；Clarithromycin；Amoxicillin. Colloidal bismuth agent；Helicobacter pylori；Chronic gastritis慢性胃炎是临床上消化系统的常见疾病，其可导致患者出现胃部不适、嗳气、泛酸、餐后慢性中上腹疼痛，患者如果得不到及时、有效的治疗，可能进一步发展成为为溃疡、穿孔、甚至癌变，严重影响了患者的生活质量和生命健康[1]，因此如何有效的进行慢性胃炎的治疗具有重要意义。

雷贝拉唑四联疗法治疗幽门螺杆菌感染消化性溃疡的临床观察佚名【期刊名称】《中国医药指南》【年(卷),期】2013(11)16【摘要】目的观察雷贝拉唑四联疗法治疗消化性溃疡的疗效及对HP感染的根除率。

方法选择我院经胃镜检查确诊及14C尿素呼气试验阳性的64例消化性溃疡患者，随机分为治疗组和对照组各32例，治疗组给予雷贝拉唑10mg 2次/d，阿莫西林1000mg 2次/d，呋喃唑酮100mg 2次/d、果胶铋150mg 3次/d，疗程7d，果胶铋再加服1周，然后单独给予雷贝拉唑20mg 1次/d继续治疗；对照组：果胶铋150mg 3次/d、阿莫西林1000mg 2次/d、呋喃唑酮100mg 2次/d，疗程7d，后单独给予果胶铋150mg 3次/d；两组总疗程十二指肠溃疡DU4周，胃溃疡GU6周，疗程结束后复查胃镜及HP以评价疗效。

结果两组主要症状的变化及腹痛消失时间比较，差异有统计学意义（P＜0.05）；治疗组和对照组总有效率分别为96.88%、78.13%，两组比较差异有统计学意义（P＜0.05）；治疗组和对照组HP根除率分别为93.75%、71.88%，两组比较差异有统计学意义（P＜0.05）；治疗组和对照组不良反应率分别为3.13%和3.13%，差异无统计学意义。

结论雷贝拉唑、阿莫西林、呋喃唑酮、果胶铋四联疗法能明显缓解消化性溃疡的症状，止痛效果快，不良反应少，对消化性溃疡有较高的治愈率及HP感染的根除率。

%Objective to observe the rabeprazole quadruple therapy treatmentof peptic ulcer and effect on helicobacter pylori infection eradication rate. Methods choose from the gastroscopy confirmed and 14C urea breath test positive of 64 cases of peptic ulcer patients, random divided intotreatment group and control group, the 32 cases of the treatment group was given rabeprazole, amoxicillin , furazolidone , pectic bismuth , 7 days treatment, pectic bismuth plus take 1 week, then separate give rabeprazole to continue treatment; Control group; bismuth pectin, amoxicillin , furazolidone 7 days after treatment, alone give pectic bismuth; Two groups of total treatment duodenal ulcer,DU 4 weeks , gastric ulcer GU 6 weeks, after the treatment the gastroscope and helicobacter pylori to evaluate curative effect. Results two groups of main symptoms change and abdominal pain disappeared time is, the difference was statistically significant (P<0.05); The treatment group and the control group total effective rate was 96.88% and 78.13%, respectively, between the two groups (P<0.05); The treatment group and the control group HP eradicate rate was 93.75% and 71.88%, respectively, between the two groups(P<0.05); The treatment group and the control group adverse reaction rate were 3.13% and 3.13% respectively, the difference was not statistically significant. Conclusion rabeprazole, amoxicillin, furazolidone, pectic bismuth quadruple therapy can obviously alleviate the symptoms of peptic ulcer, analgesic effect fast, fewer side effects, peptic ulcer have higher cure rate and the rate of helicobacter pylori infection.【总页数】2页(P423-424)【正文语种】中文【中图分类】R573.1【相关文献】1.雷贝拉唑四联疗法治疗消化性溃疡的临床观察 [J], 樊玢玫;刘金玉;杜文海2.雷贝拉唑四联疗法治疗消化性溃疡合并幽门螺杆菌感染的疗效观察 [J], 李桃;李秀梅;蒋松3.基于雷贝拉唑四联疗法初始治疗胃炎和消化性溃疡患者幽门螺杆菌感染的效果[J], 余盈娟4.雷贝拉唑四联疗法治疗幽门螺杆菌阳性消化性溃疡的临床观察 [J], 邱昌伟5.雷贝拉唑四联疗法治疗消化性溃疡的临床观察 [J], 林秀艳因版权原因，仅展示原文概要，查看原文内容请购买。

观察不同药物四联方案根除幽门螺旋杆菌(Helicobacterpylori,Hp)的疗效【摘要】目的探讨不同药物四联方案根除幽门螺旋杆菌(Hp)的疗效。

方法选取2020年4月-2021年3月本院收治的Hp感染者120例纳入研究，随机进行初治（A）、补救（B）的划分，其中A观察组（30例）阿莫西林联合多西环素，而30例A对照组（阿莫西林联合克拉霉素）；B观察组和B对照组均为30例，分别予以阿莫西林联合多西环素，阿莫西林联合左氧氟沙星，4组均埃索美拉唑、胶体果胶铋进行联合，对比疗效。

结果在PP分析下，Hp根除率A观察组96.66%与A对照组86.67%比，无统计学差异(P>0.05)；而B观察组Hp根除率83.33%，要比B对照组的60.00%高（P<0.05）；A观察组不良反应率6.67%，比A对照组36.67%低（P<0.05）；而不良反应率B观察组6.67%与B对照组10.00%比无差异(P>0.05)。

结论阿莫西林配伍多西环素四联方案，根除Hp疗效好。

【关键词】幽门螺旋杆菌；四联方案；阿莫西林[Abstract] Objective To investigate the efficacy of different drug quadruple regimens in eradicating Helicobacter pylori (HP). In 2020, 120 patients were randomly pided into two groups: the first group treated with azithromycin (a) and the first group treated with azithromycin (a) in 2020, and the first group treated withazithromycin (b) in 2020; 30 cases in observation group B and control group B were given amoxicillin combined with doxycycline andamoxicillin combined with levofloxacin respectively. The four groups were combined with esomeprazole and colloidal pectin bismuth. Results under PP analysis, the eradication rate of HP in observation group A was 96.66% compared with 86.67% in control group A, and there was no significant difference (P > 0.05); The eradication rate of HP inobservation group B was 83.33%, which was higher than 60.00% incontrol group B (P < 0.05); The adverse reaction rate of observation group A was 6.67%, which was lower than that of control group A(36.67%) (P < 0.05); The adverse reaction rate of observation group B was 6.67% and that of control group B was 10.00% (P > 0.05).Conclusion amoxicillin combined with doxycycline is effective in eradicating HP.[Key words] Helicobacter pylori; Quadruple scheme; Amoxicillin在世界范围内，Hp感染是一个普遍的问题，相关文献指出，我国发生Hp感染的概率大概达到50％【1】。