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

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 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】通过观察联合呋喃唑酮的治疗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—Effectiveness, 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呋喃唑酮的二联疗法组(A组)、联合呋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+呋喃唑酮片100mg,tid;B组:泮托拉唑胶囊40mg,bid+呋喃唑酮片100mg,tid+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。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(P<0.05),B组和C组比较无统计学意义(P>0.05)。?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%,联合呋 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 (P>0.05);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 (P<0.05),B组与C组间差异均无统计学意义(P>0.05);第5周症状 缓解情况,联合呋喃唑酮组与标准三联组间差异均无统计学意义 (P>0.05)。?药物经济学分析显示,联合呋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:呋喃唑酮、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—效果分析上看,联合呋喃 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 symptom improvement of Furazolidone-based therapy in the eradication of Helicobacter pylori infection, calculate the cost of treatment, analyze the cost-effectiveness(C/E) and aim at looking for cost-effective of treatment regimens for the eradication of Helicobacter pylori.Methods:Patients were divided randomly into three groups:one group received Furazolidone-based bigeminy therapy (Group A), the second group received Furazolidone-based triple therapy (Group B), and the third group received standard triple therapy(Group C),36 patients in each group. Group A was administered pantoprazole capsules 40mg bid plus furazolidone tablets 100mg tid, for 1 week; Group B was administered pantoprazole capsules 40mg bid plus furazolidone tablets 100mg tid plus colloidal bismuth pectin dry suspension 150mg qid, for 1 week; Group C was administered pantoprazole capsules 40mg bid plus amoxicillin dicloxacillin sodium capsules 1.5g bid plus Clarithromycin sustained-release capsules 0.5g qd, for 1 week.?Record the detailed case history of every patient; the results of their endoscopy, their treatment and countercheck; and the side effects of medications. Hp diagnosis criteria:rapid urease test positive and W-S silver staining positive. Undertake rapid urease test and W-S silver staining later. The follow-up was performed at the first week, the second week, the third week and the fifth week after the treatment.?Observe Hp eradication one month after completion of therapy.?Analyze cost-effectiveness among the above three kinds of treatments with Pharmacoeconomics.Results:2 patients missed out on follow-up in Group A,1 patient in Group B and Group C respectively.?The eradication rate of Group A, Group B and Group C were 64.7%, 91.4% and 88.6%, respectively; the difference in the eradication rate of Helicobacter pylori between Group A and Group C was significant(P<0.05), while the difference between Group B and Group C was not significant (P> 0.05).?In the first week, the incidence of side effects among Group A, Group B and Group C were 14.7%,11.4% and 8.6%, respectively; no significant difference was found (P> 0.05) between the furazolidone-based group and the standard triple group; in the second week and the fifth week, there were no further side- effects.?In the second week and the third week, there was significant difference(P<0.05)in the improvement of symptoms between Group A and Group C, while there was not significant difference(P> 0.05) between Group B and Group C in the fifth week, no significant difference was observed (P> 0.05) between the furazolidone-based group and the standard triple group.?Pharmacoeconomic analysis showed that the ratio of cost-effectiveness of the furazolidone-based triple group was obviously better than that of the standard triple group.Conclusion:The efficacy and the incidence of side-effects of the furazolidone, pantoprazole and colloidal bismuth pectin dry suspension triple therapy is similar to that of the standard triple therapy. Based on cost-effectiveness analysis, the furazolidone-based triple therapy was superior to the standard triple therapy. 【关键词】三联疗法 幽门螺杆菌 呋喃唑酮 泮托拉唑 成本-效 果分析 【英文关键词】triple therapy Helicobacter pylori Furazolidone Pantoprazole cost-effectiveness analysis 【备注】索购全文在线加好友:1.3.9.9.3.8848 同时提供论文写作一对一指导和论文发委托服务 【目录】呋喃唑酮三联疗法治疗幽门螺杆菌108例临床分析 英文缩略词表 5-6 中文摘要 6-8 Abstract 8-9 前言 10-12 材料与方法 12-18 结果 18-24 讨论 24-27 结论 27-28 参考文献 28-31 综述 31-45 参考文献 40-45 致谢 45-46 作者简介 46