诺普拉赞-阿莫西西林双疗法与不同的阿莫西西林给药方案用于Helicobacter pylori治疗:一个随机对照试验
Shuhan Qiu1, Yu Huang1, Jinnan Chen1
1NHC Key Laboratory of Digestive Diseases, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
餐后服用阿莫西西林与诺普拉赞双疗法 (VA-双疗法) 改善了Helicobacter pylori根除率. 增加阿莫西西林的频率也提高了疗效,特别是在救援治疗中.
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:
- 在Helicobacter pylori根除的诺普拉桑-氨基林双疗法 (VA-双疗法) 中,阿莫西西林的最佳施用时间和频率仍未确定.
- 之前的研究没有研究食前与食后阿莫西西林剂量对VA-双疗疗效的影响.
- 在这种疗法中,每天三次和每天四次服用阿莫西林的比较有效性也尚不清楚.
研究的目的:
- 评估不同阿莫西西林注射方案对诺普拉桑-阿莫西西林双疗法对H. pylori治疗的疗效的影响.
- 为了比较食前与食后的阿莫西西林剂量.
- 评估增加阿莫西西林剂量频率 (每天三次或四次) 对治疗结果的影响.
主要方法:
- 进行了一项随机对照试验,涉及327名H. pylori感染者.
- 参与者被分配到三个14天VA双疗组中的一个:vonoprazan 20 mg每天两次 + amoxicillin 1000 mg每天三次在饭前 (BM-TID),amoxicillin 1000 mg每天三次在饭后 (AM-TID),或amoxicillin 750 mg每天四次在饭后 (AM-QID).
- 效果,不良事件,服药性和抗生素耐药性在各组进行了比较.
主要成果:
- 在治疗意图分析中,根除率为88.1% (BM-TID),89.9% (AM-TID) 和93.6% (AM-QID).
- 修改后的治疗意图和每条协议分析显示了类似的趋势,AM-QID显示出明显高于BM-TID的有效性.
- 在这三种疗法中,在不良事件,服药性或抗生素耐药性方面没有发现显著差异.
结论:
- 餐后服用阿莫西西林和增加剂量频率 (每天四次) 可能会提高VA-双疗法对H. pylori根除的疗效.
- 与BM-TID疗法相比,AM-QID疗法显示出更高的有效性.
- 所有经过测试的VA-双疗方案都显示出对一线H. pylori治疗的良好疗效.
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