三联疗法论文：呋喃唑酮三联疗法治疗幽门螺杆菌108例临床分析

1、三联疗法论文：呋喃唑酮三联疗法治疗幽门螺杆菌108 例临床分析【中文摘要】通过观察联合咲喃唑酮的治疗方案对幽门螺杆菌感 染的根除效果、安全性及症状改善情况，计算各方案治疗费用，分析成 本-效果比（Cost Effective ness, C/E）,拟寻找一种经济有效的根除幽门螺杆菌感染的治疗方案。方法：入组患者随机分为联合咲喃唑 酮的二联疗法组（A 组）、联合咲喃唑酮的三联疗法组（B 组）及标准三 联疗法组（C 组）,每组均 36 例,疗程为 7 天。A 组：泮托拉唑胶囊 40mg,bid+咲喃唑酮片 100mg,tid ； B 组：泮托拉唑胶囊 40mg,bid+咲 喃唑酮片100mg,ti

2、d+胶体果胶铋干混悬剂 150mg,qid ;C 组为对照组：泮托拉唑胶囊40mg,bid+阿莫西林双氯西林钠胶囊 1.5g,bid+克拉霉 素缓释胶囊 0.5g,qd。对每名患者进行详细病史采集，对一般资料、 胃镜检查结果、治疗后复查等进行详细记录。Hp 感染诊断方法为： 快速尿素酶试验和 W-S 银染色镜检,两者均阳性诊断为 Hp 感染。治疗 后，于第 Q 周、第 2 周、第 3 周和第 5 周对患者进行随访，详细记录症 状的改善情况、服药情况、不良反应等资料。治疗结束后停药 4 周 复查 Hp,观察各组的 Hp 根除效果。入组患者钳取胃粘膜做快速尿素 酶试验及 W-S 银染色镜检。用药物

3、经济学分析三种方案的成本-效果比。结果：A 组 2 例失访,B 组、C 组各有 1 例。A 组、B 组、C 组 Hp根治率分别为 64.7%、91.4%和 88.6%,A 组与 C 组比较差异有统计 学意义（P0.05）。A 组、B 组和 C组第 1 周不良反应发生率分别为 14.7%、11.4%及 8.6%,联合咲 喃唑酮组与标准三联组间不良反应发生率差异无统计学意义 (P0.05);第 2 周和第 5周未出现不良反应。 A 组、 B 组及 C 组在 第 2 周、 第 3 周症状改善情况,A组与 C 组间差异均有统计学意义 (P0.05);第 5 周症状 缓解情况,联合咲喃唑酮组与标准三联组

4、间差异均无统计学意义 (P0.05)。药物经济学分析显示，联合咲喃唑酮的三联疗法成本- 效果比明显优于标准三联疗法。结论：咲喃唑酮、泮托拉唑与胶体果 胶铋干混悬剂三联疗法与标准三联疗法在根除幽门螺杆菌感染上疗效及不良反应发生率基本相似，但从成本一效果分析上看，联合咲喃 唑酮的三联疗法明显具有较大优势。【英文摘要】：To observe the efficacy, safety and symptomimproveme nt of Furazolid on e-based therapy in the eradicati on ofHelicobacter pylori in fecti on,

5、 calculate the cost of treatme nt, an alyze thecost-effective ness(C/E) and aim at looki ng for cost-effective of treatme ntregime ns for the eradication of Helicobacter pylori.Methods:Patients weredivided ran domly into three groups: one group received Furazolidone-based bigem iny therapy (Group A)

6、, the sec ond group receivedFurazolido ne-based triple therapy (Group B), and the third group receivedsta ndard triple therapy(GroupC),36 patie nts in each group. Group A was adm ini stered pantoprazolecapsules 40mgbid plus furazolidone tablets 100mg tid, for 1 week; GroupB was administered pantopra

7、zole capsules 40mg bid plus furazolido netablets 100mg tid plus colloidal bismuth pectin dry suspension 150mg qid,for 1 week; Group C was adm ini stered pan toprazole capsules 40mg bidplus amoxicilli n dicloxacilli n sodium capsules 1.5g bid plusClarithromycinsustained-release capsules 0.5g qd, for

8、1 week.1Record the detailed case history of every patie nt; theresults of their endoscopy, theirtreatment and countercheck;and the side effects of medicati ons. Hp diag no sis criteria:rapid ureasetest positive and W-S silver staining positive. Un dertake rapid urease testand W-S silver sta ining la

9、ter. The follow-up was performed at the firstweek, the sec ond week, the third week and the fifth week after the treatment.2Observe Hperadicationone month after completion of therapy.3An alyze cost-effective ness among the above three kinds of treatments with Pharmacoec ono mics.Results:2 patie nts missed out on follow-upin Group A,1 patie nt in Group B and Group C respectively. Theeradicati on rate of Group A, Group B and Group C were 64.7%, 91.4