优化序列治疗与10日和14日同时治疗以消灭Helicobacter pylori:一个随机临床试验
Hassan Seddik1,2, Jihane Benass1,3, Sanaa Berrag2,4
1Department of Gastroenterology II, Mohammed V Military Teaching Hospital of Rabat, Rabat 10100, Morocco.
World journal of gastroenterology
|March 11, 2024
概括
优化的14天顺序治疗 (OST-14) 提供了一种高效和安全的替代方案,用于根除Helicobacter pylori (H. pylori) 感染. 这种方法的疗效与标准的四重疗法相当,但副作用显著减少,成本效益提高.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 根除Helicobacter pylori (H. pylori) 仍然是一个全球卫生挑战,原因是抗菌素耐药性日益增加.
- 优化序列疗法是改善治疗疗效,耐受性和成本效益的关键策略.
- 质子抑制剂 (PPI) 通过保持最佳的胃pH,对抗生素有效性至关重要.
研究的目的:
- 为了比较一个优化的14天连续治疗 (OST-14) 与标准的10天 (QT-10) 和14天 (QT-14) 的非比斯木四重疗法对H. pylori根除的疗效,安全性和成本.
主要方法:
- 一项前性开放性研究将328名感染H. pylori的患者随机分为三个组.
- 第1组接受了为期10天的四重疗法 (QT-10).
- 第二组接受了为期14天的四重疗法 (QT-14).
- 第三组接受了14天的优化序列治疗 (OST-14),使用拉贝普拉和阿莫西西林,其次是拉贝普拉,克拉里思罗米辛和美特罗尼达.
- 通过13C尿素呼吸试验评估有效性,并记录了不良反应.
主要成果:
- 与QT-10组相比,OST-14组的根除率显著更高 (93.5%与85.5%的ITT相比;96.2%与89.5%的PP相比).
- 在OST-14和QT-14组之间没有观察到消除率的显著差异 (93.5%对91.8%ITT;96.2%对94.4%PP).
- 在OST-14组中,不良反应的发生率明显较低 (P=0.01).
- 确定OST-14是最具成本效益的治疗策略.
结论:
- 优化14天顺序治疗 (OST-14) 是一种安全有效的替代方案,可以消除H. pylori.
- OST-14的根除率与14天的并发疗法相提并论.
- OST-14具有较少不良影响和更好的成本效益的优势.
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