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目的评价基于莫西沙星的三联疗法作为幽门螺杆菌(Hp)感染二线治疗的疗效和安全性。方法将74例经标准三联疗法治疗失败的Hp感染患者随机分为A组和B组,两组均为37例。A组给予口服雷贝拉唑10mg+阿莫西林1g+莫西沙星400mg,均为2次/d;B组给予口服雷贝拉唑10mg(2次/d)+枸橼酸铋钾300mg(4次/d)+甲硝唑(400mg,3次/d)+四环素(500mg,3次/d)。两组均治疗7d,疗程结束后4周复查~(14)C尿素呼气试验。结果按意向治疗分析A组和B组的Hp根除率分别为78.4%和56.8%,差异有统计学意义(P=0.047);按符合方案分析A组和B组的Hp根除率分别为85.3%和70.0%,差异无统计学意义(P=0.140)。两组的不良反应率分别为10.8%和27.0%,差异无统计学意义(P=0.075)。结论含莫西沙星的三联方案优于含铋剂的四联方案,是一种疗效好且安全性高的Hp根除二线疗法。
Objective To evaluate the efficacy and safety of moxifloxacin-based triple therapy as second-line treatment of Helicobacter pylori (Hp) infection. Methods Totally 74 patients with Hp infection who failed the standard triple therapy were randomly divided into A group and B group, 37 cases in both groups. Group A was given oral rabeprazole 10mg + amoxicillin 1g + moxifloxacin 400mg, were 2 times / d; Group B was given oral rabeprazole 10mg (2 times / d) + bismuth potassium citrate 300mg (4 times / d) + metronidazole (400 mg, 3 times / d) + tetracycline (500 mg, 3 times / d). Both groups were treated for 7 days, 4 weeks after the end of the course of review ~ (14) C urea breath test. Results According to the intention-to-treat analysis, the Hp eradication rates of group A and group B were 78.4% and 56.8%, respectively, with significant difference (P = 0.047). According to the protocol, the Hp eradication rates of group A and group B were 85.3% And 70.0%, the difference was not statistically significant (P = 0.140). Adverse reactions in both groups were 10.8% and 27.0%, respectively, with no significant difference (P = 0.075). Conclusion The triple combination regimen containing moxifloxacin is superior to the quadruple combination bismuth containing regimen, which is a second-line Hp eradication therapy with good efficacy and safety.