论文部分内容阅读
目的:通过观察奥美拉唑、克拉霉素、阿莫西林、甲硝唑、呋喃唑酮不同分组短程三联疗法的临床疗效,确定青岛地区用于治疗幽门螺杆菌抗生素的耐药率,选择最合适的三联治疗方案,避免新的耐药菌株的出现。方法:396例消化性溃疡或浅表性胃炎合并幽门螺杆菌阳性患者,随机分为3组:①奥美拉唑20mg+克拉霉素500mg+阿莫西林1000mg组,132例;②奥美拉唑20mg+阿莫西林1000mg+甲硝唑400mg组,132例;③奥美拉唑20mg+阿莫西林1000mg+呋喃唑酮100mg组,132例。2次/d,每个疗程7d。抗幽门螺杆菌治疗结束后1个月,全部做胃镜检查。结果:3组幽门螺杆菌的根除率分别为86.12%(112/130)、59.23%(77/130)和92.24%(122/132),耐药率分别为13.88%、40.77%和7.58%,①组和③组间差异无统计学意义(χ2=2.7,P>0.05),而②组的根除率、耐药率与①组和③组间经χ2检验,差异有统计学意义(P<0.01)。3组的消化性溃疡愈合率分别为61.11%、48.64%和82.86%,①组和②间差异无统计学意义(χ2=1.14,P>0.05),③组与①组和②组间经χ2检验,差异有统计学意义(P<0.01);不良反应发生率分别为2.3%(3/130)、8.5%(11/130)和6.1%(8/132)。结论:青岛地区根除幽门螺杆菌的三联疗法首选方案为:①奥美拉唑20mg+克拉霉素500mg+阿莫西林1000mg组和③奥美拉唑20mg+阿莫西林1000mg+呋喃唑酮100mg组。
OBJECTIVE: To determine the clinical efficacy of short-course triple therapy in different groups of omeprazole, clarithromycin, amoxicillin, metronidazole and furazolidone to determine the rate of resistance to antibiotics used in the treatment of H. pylori in Qingdao. The most suitable Triple therapy programs to avoid the emergence of new drug-resistant strains. Methods: 396 cases of peptic ulcer or superficial gastritis with Helicobacter pylori positive patients were randomly divided into three groups: ① omeprazole 20mg + clarithromycin 500mg + amoxicillin 1000mg group, 132 cases; ② omeprazole 20mg + Amoxicillin 1000mg + metronidazole 400mg group, 132 cases; ③ omeprazole 20mg + amoxicillin 1000mg + furazolidone 100mg group, 132 cases. 2 times / d, each course of 7d. Anti-Helicobacter pylori treatment after 1 month, all done gastroscopy. Results: The eradication rates of Helicobacter pylori in three groups were 86.12% (112/130), 59.23% (77/130) and 92.24% (122/132), respectively. The drug resistance rates were 13.88%, 40.77% and 7.58% There was no significant difference between group ① and ③ (χ2 = 2.7, P> 0.05), while the eradication rate and drug resistance of group ② were significantly different from those of group ① and ③ by χ2 test (P < 0.01). The healing rates of peptic ulcer in the three groups were 61.11%, 48.64% and 82.86% respectively. There was no significant difference between the two groups (χ2 = 1.14, P> 0.05) The difference was statistically significant (P <0.01). The incidence of adverse reactions were 2.3% (3/130), 8.5% (11/130) and 6.1% (8/132) respectively. Conclusion: The first choice of triple therapy for Helicobacter pylori eradication in Qingdao is as follows: omeprazole 20mg + clarithromycin 500mg + amoxicillin 1000mg group and omeprazole 20mg + amoxicillin 1000mg + furazolidone 100mg group.