本文選題：螺桿菌感染 + 幽門螺桿菌��； 參考：《中國全科醫(yī)學(xué)》2017年18期

【摘要】：目的明確含米諾環(huán)素的四聯(lián)方案在幽門螺桿菌(H.pylori)感染復(fù)治患者中應(yīng)用的安全性、患者依從性、根除治療成功率及其影響因素,以期為臨床H.pylori感染復(fù)治患者的根除治療提供新的選擇。方法選擇2013年8月—2015年8月于北京積水潭醫(yī)院就診的H.pylori感染復(fù)治患者180例為研究對象。采用含米諾環(huán)素的四聯(lián)方案,具體為雷貝拉唑(10 mg/次,2次/d)+阿莫西林(1.0 g/次,2次/d)+米諾環(huán)素(0.1 g/次,2次/d)+枸櫞酸鉍鉀(220 mg/次,2次/d);療程14 d。治療結(jié)束后3~7 d觀察患者不良反應(yīng)情況、依從性;治療結(jié)束后4~12周通過意向性治療(ITT)分析及遵循方案(PP)分析評估根除治療成功率。結(jié)果 ITT分析納入180例患者;6例患者因失聯(lián)、未按時復(fù)查,4例患者因依從性差予以剔除,PP分析納入170例患者。共有56例(31.1%)患者出現(xiàn)不良反應(yīng),其中腹瀉者31例(55.4%),頭暈失眠者28例(50.0%),上腹不適、惡心者各23例(41.1%),各不良反應(yīng)在停藥后均完全消失。依從性好者165例(91.7%)。ITT分析根除治療成功率為79.4%(143/180),PP分析根除治療成功率為84.1%(143/170)。女性患者PP分析根除治療成功率高于男性(P0.05);不同年齡、吸煙情況、既往根除治療次數(shù)、既往根除治療方案患者PP分析根除治療成功率比較,差異無統(tǒng)計學(xué)意義(P0.05)。多元Logistic回歸分析結(jié)果顯示,性別、年齡、吸煙情況、既往根除治療次數(shù)、既往根除治療方案均不是PP分析根除治療成功率影響因素(P0.05)。結(jié)論含米諾環(huán)素的四聯(lián)方案在H.pylori感染患者復(fù)治中有較好的根除治療成功率,安全性及依從性尚可,是H.pylori感染患者復(fù)治的新選擇。
[Abstract]:Objective to identify the safety of the four regimen of minocycline in the retreated patients with Helicobacter pylori (H.pylori), patient compliance, the success rate of eradication and its influencing factors, in order to provide a new choice for the eradication treatment of the retreated patients with clinical H.pylori infection. In August 2013 and August 2015, Fang method chose the Beijing quaitan medicine 180 patients with H.pylori infection were treated with a quadruple regimen including minocycline (10 mg/ times, 2 times /d) + amoxicillin (1 g/ times, 2 /d) + minocycline (0.1 g/ times, 2 /d) + bismuth citrate (220 mg/ times, 2 times / D), and 14 d. after the treatment of 14 D., 3~7 D observed the adverse reaction of patients after 3~7 D observed patients after treatment, depending on the course of treatment. After the end of the treatment, 4~12 weeks after 4~12 weeks were analyzed and followed by a program (ITT) analysis and program (PP) analysis to evaluate the success rate of eradication. Results ITT analysis was included in 180 patients; 6 patients were not rechecked because of loss of union, 4 patients were excluded because of poor compliance, and PP analysis was included in 170 patients. 56 cases (31.1%) had adverse reactions. 31 cases of diarrhea (55.4%), 28 cases of dizziness and insomnia (50%), upper abdominal discomfort, 23 cases of nausea (41.1%), all adverse reactions were completely disappeared after withdrawal. 165 cases with good compliance (91.7%).ITT analysis was 79.4% (143/180), and PP analysis was 84.1% (143/170). The success rate of PP analysis in female patients was high. There was no significant difference between men (P0.05), age, smoking, previous eradication times, and previous eradication therapy in patients with PP analysis, the difference was not statistically significant (P0.05). Multiple Logistic regression analysis showed that sex, age, smoking, previous eradication treatment times, and previous eradication treatments were not PP analysis. Conclusion the quadruple program containing minocycline has a good success rate of eradication, safety and compliance in the retreatment of H.pylori infected patients. It is a new choice for the retreatment of patients with H.pylori infection.
【作者單位】： 北京積水潭醫(yī)院消化科;
【分類號】：R573
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本文編號：2101449