| 摘要: |
| 目的:评价序贯疗法(sequential treatment regimen)与标准三联疗法对幽门螺杆菌(Helicobacter pylori，Hp)阳性功能性消化不良(functional dyspepsia，FD)患者根除Hp效果及症状改善情况。方法:Hp阳性的130例FD患者随机分为2组:S组给予奥美拉唑20 mg、阿莫西林1 000 mg 口服5 d后再给予奥美拉唑20 mg、克拉霉素500 mg和替硝唑400 mg口服5 d，均2次/d；T组给予奥美拉唑20 mg、克拉霉素500 mg和阿莫西林1 000 mg口服7 d，均2次/d；治疗后4周及随访1年后行快速尿素酶试验和14C-尿素呼气试验，并对症状进行评分。结果:S组按意图治疗(ITT)Hp根除率为83.58%(56/67)，按试验方案(PP)分析为91.80％(56/61)；T组根除率按ITT分析为65.08%(41/63)，按PP分析为69.49%(41/59)，均显著低于S组(P＜0.05)。Hp根除组患者治疗前症状评分为4.88±1.76，1年后为2.18±0.83，差异有统计学意义(P＜0.05)；Hp持续感染组患者治疗前症状评分为4.99±1.66，随访1年后为3.89±1.56，差异无统计学意义。结论:序贯疗法对Hp阳性FD患者Hp根除效果明显好于标准三联疗法，Hp根除后消化不良症状可显著改善。 |
| 关键词: 序贯疗法 幽门螺杆菌 功能性消化不良 |
| DOI：10.3724/SP.J.1008.2008.00908 |
| 投稿时间：2007-09-04修订日期：2008-06-20 |
| 基金项目: |
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| Treatment outcomes of functional dyspepsia patients with Helicobacter pylori infection:a comparison between sequential treatment regimen and conventional triple therapy |
| MA Chun-xi1,PENG Guo-lin1,ZHAO Yong-kai1,ZHANG Xiao-yun2,ZHAN Li-ying1 |
| (1.Department of Gastroenterology,No.184 Hospital of PLA,Yingtan 33500,China;2.Department of Laboratory Diagnosis,No.184 Hospital of PLA,Yingtan 33500) |
| Abstract: |
| Objective:To compare the eradication rates of H.pylori infection between a new sequential treatment regimen and conventional triple therapy in functional dyspepsia patients,and to assess the symptom improvement of functional dyspepsia.Methods: One hundred and thirty functional dyspeptic patients with H.pylori infection were randomly divided into 2 groups.Patients in sequential treatment group received 10-day sequential therapy:omeprazole (40 mg daily) plus amoxicillin (1 g twice daily) for the first 5 days,followed by omeprazole (20 mg),clarithromycin (500 mg) and tinidazole (500 mg) twice daily for the another 5 days; patients in triple therapy group received standard 7-day treatment:omeprazole (20 mg),clarithromycin (500 mg) and amoxicillin (1 g) twice daily for 7 days.H.pylori statuses were assessed by rapid urease test and 14C-urea breath test at base line level 4 weeks and one year after treatment，and symptom scores in various H.pylori statuses were evaluated.Results: The eradication rates of H.pylori in the sequential treatment group was 83.58%(56/67)by intention-to-treat(TTI)analysis and 91.80％(56/61) by per-protocol(PP)analysis,and the numbers in the triple therapy group were 65.08%(41/63)and 69.49%(41/59),respectively,which were significantly lower than those in the sequential treatment group (P<0.05). The symptom scores of patients with H.pylori eradicated after treatment were 4.88±1.76 before treatment and 2.18±0.83 one year after treatment (P<0.05); the scores of patients whose H.pylori was not eradicated after treatment was 4.99±1.66 before treatment and 3.89±1.56 one year later; there was no significant difference between the 2 numbers.Conclusion: Sequential treatment regimen has a better H.pylori eradication effect for functional dyspepsia patients positive of H.pylori than standard triple therapy; the symptom of dyspepsia can be greatly improved after H.pylori eradication． |
| Key words: sequential treatment regimen Helicobacter pylori functional dyspepsia |
