含铋剂四联疗法作为一线方案根治幽门螺杆菌感染的临床研究

【】　目的　探讨含铋剂的四联疗法作为一线方案对幽门螺杆菌感染的有效性和安全性。　方法　选择2008年9月-2010年9月间137例确诊幽门螺杆菌感染的初治患者，随机分为RAC组（雷贝拉唑、阿莫西林和克拉霉素）和RBAC组（雷贝拉唑、阿莫西林、克拉霉素和枸橼酸铋钾）。经治疗7d后比较两组根除率和不良反应发生率。　结果　RAC组和RBAC组的按方案分析根除率分别为77.6%和90.3%，意向性治疗分析根除率分别为72.6%和86.7%。RBAC组的按方案分析和意向性治疗分析根除率均高于RAC组（P0.05）。　结论　以雷贝拉唑、阿莫西林、克拉霉素和枸橼酸铋钾为组合的四联疗法能显著提高幽门螺杆菌感染的初治成功率，不良反应少，安全有效。【Abstract】　Objective　Toinvestigatetheeffectivenessandsafetyofthequadrupletherapycontainingabismuthcompoundforfirst-lineHelicobacterpylorieradicationtreatment.　Methods　Atotalof137patientsdiagnosedtobeHelicobacterpylori-positivebetweenSeptember2008andSeptember2010wererandomizedintotwogroupstoreceivethecombinationofrabeprazole,amoxicillinandclarithromycin(RACgroup)andthecombinationofrabeprazole,amoxicillin,clarithromycinandbismuthpotassinmcitrate(RBACgroup)respectively.Theefficacyandtolerancewereobservedafterthetreatmentfor7days.　Results　Theperprotocol(PP)eradicationratesofHelicobacterpyloriwere86.7%forRACgroupand90.3%forRBACgroup(P0.05).　Conclusion　Thequadrupletherapycontainingrabeprazole,amoxicillin,clarithromycinandbismuthpotassinmcitrateprovidesagooderadicationrateofHelicobacterpyloriwithagoodcompliancewhencomparedwiththestandardtripletherapyschemes.