Objective: To assess the efficacy and safety of a 10-day sequential regimen compared with conventional 7-day and 14-day triple therapies. Methods: Overall, 113 Helicobacter pylori (H. pylori) infected patients with peptic ulcer were enrolled. All patients were randomized either to receive 10-day sequential therapy Group A, pantoprazole plus amoxicillin for the first 5 days, followed by pantoprazole, clarithromycin and tinidazole twice daily for the remaining 5 days or to standard 7-day therapy Group B, pantoprazole,clarithromycin and amoxicillin twice daily, or standard 14-day therapy Group C. Four weeks after therapy. H. pylori eradication was assessed by 14C-urea breath test. Results: H. pylori eradication was achieved in 34 (87. 18％) of 39 individuals in Group A, 34 (91.89％)of 37 in Group C and 30 (81.08％) of 39 in Group B Sequential regimen and the 10-day showed a significant gain in the eradication rate as compared to the 7-day (P＜ 0. 05) while there was no significant difference between Group A and Group C (P＞0. 05). Adverse drug events were similar in these three groups. Conclusions: The sequential regimen and standard 14-day therapy achieved higher cure rate than standard 7-day therapy. The sequential regimen had the lowest cost-effective ratio. The 10-day sequential regimen is significantly more effective, economic and safe than both triple regimens.%目的:比较10 d序贯疗法与7 d及14 d三联疗法根治幽门螺杆菌(Hp)的疗效与安全性.方法:选取113例胃镜证实为消化性溃疡行14C尿素呼气试验Hp阳性患者,随机分为3组:A组(序贯疗法组)前5 d给予泮妥拉唑和阿莫西林,后5 d给予泮妥拉唑、替硝唑、克拉霉素治疗;B组(7 d疗法)给予泮妥拉唑、阿莫西林、克拉霉素治疗,病理为7 d;C组(14 d疗法)方案同7 d疗法,疗程为14 d.疗程结束1个月后行14C尿素呼气试验.结果:A组根除率为87.18%(34/39),C组根除率为91.43%(34/37),均高于B组根除率81.08%(30/37)(P<0.05),A组与C组根除率比较无显著差别(P>0.05).3组不良反应发生率分别为:15.38%、13.51%和18.91%,相互比较均无显著差异,A组费用效益比好于B组和C组.结论:10 d序贯疗法疗效与14 d三联疗法的疗效均好,序贯疗法费用效益比最低.10 d序贯疗法安全、有效、经济.
展开▼
