| Objective:? The aim of this study was to investigate the risk factors of Helicobacter pylori infection in patients with chronic gastritis and evaluate the efficacy of 1 week triple therapy of esomeprazole, levofloxacin, amoxicillin and clavulante potassium combined for Helicobacter pylori eradication.Methods:1. 345 cases with chronic gastritis were diagnosed by gastroscopy and (or) histopathological examination, a unified questionnaire survey was conducted, Helicobacter pylori infection was assessed by detecting the 14C-urea breath test. The 191 positive cases were arranged for case group, the 154 negative cases for control group. Using the case-control study method, the univariable and multivariable analyses were carried out by the Chi-Square Tests and Logistic regression method on the associated risk factors.2. 80 patients with Helicobacter pylori infection suffering from chronic gastritis were randomized to treatment group and control group. The treatment group were administered esomeprazole (40mg, once daily), levofloxacin (200mg, twice daily), amoxicillin and clavulante potassium (457mg, twice daily)for 1 week. The control group were administered esomeprazole (40mg, once daily), clarithromyicn (250mg, twice daily), amoxicillin and clavulante potassium (457mg, twice daily) for 1 week. Symptoms were recorded by using a scoring system, side-effects were recorded during treatment. Tongue picture examination and 14C-urea breath test were performed before the treatment and completion of therapy 4 weeks after stopping.Results:1. The results of single factor analysis showed that the Helicobacter pylori infection was relative significantly to the education background , living areas, eating outside, eating speed, engorgement, vinegar, preference of spicy food, food fried in oil and mental stress(P<0.05). The results of the multivariable unconditional Logistic regression analysis showed that the Helicobacter pylori infection was relative significantly to the education background, eating outside, engorgement, vinegar and preference of spicy food. Helicobacter pylori infection was negatively associated with the education background and vinegaron(OR=0.781, 0.652～0.935, P=0.007; OR=0.600, 0.383～0.942, P=0.026), but positively associated with eating outside, engorgement and preference of spicy food(OR=1.853, 1.181～2.908, P=0.007; OR=1.781, 1.121～2.830, P=0.014; OR=1.210, 1.036～1.413, P=0.016).2. 76 patients completed in the whole trial, 4 patients were lost in the follow-up.2.1 Symptom improvement, there is improvement in main symptoms both the treatment group and control group, the treatment group on improvement in anorexia is better than the control group(χ2=6.692, P=0.035), while improvements of other symptoms compared with the control group, the differences were no statistic meaning.2.2 Changes of tongue coating, there were significant differences between the treatment group and control group, while changes of tongue-quality compared with the control group, the differences were no statistic meaning.2.3 The Helicobacter pylori eradication rate between the treatment group and control group were 92.1%, 73.7%, respectively, the treatment group is significantly higher than the control group(P=0.033).2.4 Side-effects rate between the treatment group and control group were 13.2% and 15.8%, respectively, the difference was no statistic meaning(P>0.05).Conclusion:1. Eating outside frequently and engorgement and preference of spicy food could increase the risk of Helicobacter pylori infection, increasing degrees of education and proper use of vinegar could decrease the risk of Helicobacter pylori infection.2. Triple therapy of esomeprazole, levofloxacin, amoxicillin and clavulante potassium combined for 1 week can effectively eradicate Helicobacter pylori, so such therapy is the first choice for treatment of Helicobacter pylori infection. |
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