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目的:比较莫西沙星序贯疗法与镶嵌疗法根除幽门螺旋杆菌(Helicobacter pylori,Hp)的临床有效性。方法:选取2012年5月至2015年11月于我院治疗的144例Hp感染患者为研究对象,随机分为A、B两组,每组72例,分别接受14日莫西沙星序贯疗法和14日镶嵌疗法。治疗后4周~(13)C-urea呼气试验结果为阴性者定义为Hp根除成功;患者的药物摄入率超过85%定义为依从性良好。记录患者的Hp根除率、治疗依从率及不良反应发生率。结果:A组患者意向治疗(intention-to-treat,ITT)分析根除率为91.7%(66/72,95%CI 90.1%~92.8%),高于B组的79.2%(57/72,95%CI 77.2%~80.6%),且组间差异具有统计学意义(P=0.02)。A组患者方案(per protocol,PP)分析根除率为94.3%(66/70,95%CI 92.8%~95.5%),明显高于B组的83.8%(57/68,95%CI 80.5%~84.0%,P=0.005)。另外,A组的不良反应发生率低于B组(11.4%vs 20.6%,P=0.03)。结论:作为Hp一线治疗方案,14日莫西沙星序贯疗法与14日镶嵌疗法相比具有更高的Hp根除率、治疗依从性及更低的不良反应发生率。
Objective: To compare the clinical efficacy of sequential therapy and mosaic therapy of moxifloxacin in the eradication of Helicobacter pylori (Hp). Methods: A total of 144 patients with Hp infection treated in our hospital from May 2012 to November 2015 were randomly divided into A and B groups, with 72 patients in each group receiving sequential treatment of Moxifloxacin And 14 inlaid therapy. 4 weeks after treatment ~ (13) C-urea breath test negative results were defined as successful Hp eradication; patients with more than 85% drug intake were defined as good compliance. Records of patients with Hp eradication rate, treatment compliance and adverse reaction rates. Results: In the group A, the intention-to-treat (ITT) analysis of eradication rates was 91.7% (66/72, 95% CI 90.1% -92.8%), which was significantly higher than 79.2% (57/72, 95% % CI 77.2% ~ 80.6%), and the difference between groups was statistically significant (P = 0.02). The eradication rate of per protocol (PP) in group A was 94.3% (66/70, 95% CI 92.8% -95.5%), which was significantly higher than 83.8% (57/68, 95% CI 80.5% 84.0%, P = 0.005). In addition, the incidence of adverse reactions in group A was lower than in group B (11.4% vs 20.6%, P = 0.03). Conclusions: As a first-line treatment of Hp, sequential treatment with 14-day moxifloxacin has higher Hp eradication rate, treatment compliance and lower incidence of adverse reactions than 14-day MIT.