Comparison Between The Efficacy Of Minocycline-Based Vs Furazolidone-Based Bismuth Quadruple Therapy In Initial Treatment For Helicobacter Pylori Infection

Objective: With the increase of resistance rate of Helicobacter pylori(H.pylori),the efficacy of many eradication programs has decreased,and now people’s understanding of the eradication of Helicobacter pylori and efficacy requirements are also improved,therefore,it is urgent to explore new therapeutic drugs and programs.At present,there is no consensus on the efficacy and safety of Minocyclinecontaining bismuth quadruple regimen.In this study,by comparing and analyzing the efficacy of initial eradication of H.pylori with Minocycline and Furazolidone-containing bismuth quadruple regimen,to explore safer and more effective quadruple eradication programs.Methods: From March 2021 to October 2022,160 H.pylori positive patients who were treated by the Department of Gastroenterology of Jining First People’s Hospital due to upper gastrointestinal discomfort were selected and randomly divided into Minocycline(MINO)group and Furazolidone(FZD)group with 80 cases each.MINO group: rabeprazole20 mg bid,minocycline 100 mg bid,amoxicillin 1g bid,bismuth potassium citrate 220 mg bid,treatment course 14 days.FZD group:rabeprazole 20 mg bid,furazolidone 100 mg bid,amoxicillin 1g bid,bismuth potassium citrate 220 mg bid,course of treatment 14 days.Patients’ adverse drug reactions,clinical symptom relief,drug compliance and 13C-or 14C-urea breath test results over 4 weeks after treatment termination were recorded by telephone or outpatient follow-up.The eradication rate,incidence of adverse reactions,drug compliance,symptom remission rate,cost-effectiveness ratio and incremental costeffectiveness ratio of the two groups were analyzed and compared.Results: The eradication rates in the MINO group and the FZD group were 88.75% and 86.25% in ITT analysis,and 92.21% and 90.79%in PP analysis respectively,and there was no significant difference in eradication rate between the two groups(P>0.05);The incidence of adverse reactions in the MNIO group and FZD group was 16.9% and14.5% respectively,with no significant difference(P>0.05);The adherence of patients in MINO group and FZD group was 96.1% and94.7% respectively,and the difference was not statistically significant(P>0.05);The clinical symptom response rates in the MINO group and the FZD group were 89.6% and 86.8% respectively,and the difference was not statistically significant(P>0.05);The cost-effect ratios of MINO group and FZD group were 3.60 and 2.21 respectively,and the incremental cost-effect ratio of MINO group compared with FZD group was 92.39.Conclusion: Both the quadruple regimen containing minocycline and bismuth containing furazolidone can achieve satisfactory eradication effects,while the quadruple regimen containing bismuth containing Furazolidone has more cost advantages.Both regimens are efficient,safe and economical treatment regimens,worthy of clinical application.