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目的回顾性分析我国南、北方两市应用两种不同的三联疗法根除慢性胃炎患者幽门螺杆菌(Hp)的临床疗效。方法选择幽门螺杆菌(Hp)感染的慢性糜烂性胃炎或浅表性胃炎(非萎缩性胃炎)患者各120例,分为4组,即百色克拉霉素组,百色甲硝唑组,丹东克拉霉素组,丹东甲硝唑组,每组60例。克拉霉素组和甲硝唑组分别采用“奥美拉唑+阿莫西林+克拉霉素”和“奥美拉唑+阿莫西林+甲硝唑”两种三联疗法,疗程均为7d。服药期间电话随访,记录服药、症状变化及患者的耐受性等情况。并于停药后第1天和4周后进行相关项目复查。结果百色克拉霉素组、百色甲硝唑组、丹东克拉霉素组、丹东甲硝唑组四组Hp的根除率分别为:81.67%、33.33%、85.00%和41.67%;四组的慢性糜烂性胃炎愈合率分别为92.00%、66.67%、89.29%、65.38%。不同市克拉霉素组之间及不同甲硝唑组之间Hp根除率、糜烂愈合率分别比较,结果均无显著性差异(P>0.05),同克拉霉素组与甲硝唑组之间比较,Hp根除率具有高度显著性差异(P<0.01),糜烂愈合率有显著性差异(P<0.05)。四组不良反应率无显著性差异(P>0.05)。结论“奥美拉唑+阿莫西林+克拉霉素”三联疗法适用于南方和北方不同省市病例,Hp根除率高,疗效肯定,且药物不良反应低,患者耐受性好,适合临床应用。Hp对甲硝唑耐药具有普遍性和广泛性。
Objective To retrospectively analyze the clinical effects of two different triple therapy in the south and north of China on the eradication of Helicobacter pylori (Hp) in patients with chronic gastritis. Methods A total of 120 patients with chronic erosive gastritis or superficial gastritis (non-atrophic gastritis) infected with Helicobacter pylori (Hp) were divided into 4 groups: Baishikangmycin, Baise Metronidazole and Dandong Kela ADM group, Dandong metronidazole group, 60 cases in each group. Clarithromycin group and metronidazole group were used “omeprazole + amoxicillin + clarithromycin” and “omeprazole + amoxicillin + metronidazole ” two triple therapy, treatment All 7d. Telephone follow-up during medication, record medication, symptoms and patient tolerance and so on. And in the first day after stopping and 4 weeks after the relevant items for review. Results The eradication rates of Hp in the groups Baise Clarithromycin, Baise Metronidazole, Dandong Clarithromycin and Dandong Metronidazole were 81.67%, 33.33%, 85.00% and 41.67% respectively. The four groups of chronic erosions Gastritis healing rates were 92.00%, 66.67%, 89.29%, 65.38%. There was no significant difference (P> 0.05) between Hp eradication rate and erosion healing rate among clarithromycin groups and metronidazole groups in different cities, with no difference between clarithromycin group and metronidazole group Hp eradication rate was highly significant difference (P <0.01), erosion healing rate was significantly different (P <0.05). There was no significant difference in adverse reactions between the four groups (P> 0.05). Conclusion “omeprazole + amoxicillin + clarithromycin” triple therapy is suitable for different provinces and cities in the South and North China, Hp eradication rate, positive effect, and adverse drug reactions, patients with good tolerance, suitable Clinical application. Hp resistance to metronidazole is universal and extensive.