Efficacy,Safety And Influencing Factors Of Different Helicobacter Pylori Treatment Regimens Based On Doxycycline

Objective: To investigate the efficacy and safety of different doxycycline-based treatment regimens for Helicobacter pylori(H.pylori).Methods: The clinical data of 1586 patients diagnosed with H.pylori infection in the outpatient department of gastroenterology of the Third Xiangya Hospital from January 2015 to January 2022 were retrospectively analyzed,and they were divided into four groups according to different H.pylori treatment regimens:Group A: Doxycycline + Furazolidone +Colloidal bismuth tartrate + Eprazole;Group B:Doxycycline + Amoxicillin+ Colloidal bismuth tartrate + Eprazole;Group C: Saccharomyces boulardii was added on the basis of group A;Group D: Saccharomyces boulardii was added on the basis of group B.There were 872 cases in group A,362 cases in group B,163 cases in group C,and 189 cases in group D.The course of treatment of the four groups was 14 days.The course of treatment for the four groups is 14 days.All patients underwent outpatient13C-urea breath test or 14C-urea breath test at least 4 weeks after drug withdrawal to observe the eradication rate of H.pylori,the incidence of adverse drug reactions,and the cost-effectiveness ratio.According to the results of H.pylori eradication,they were divided into eradication success group(1460 cases)and eradication failure group(126 cases).Univariate analysis was performed on factors such as gender,age,and marital status,and multivariate Logistic regression analysis was performed on the univariate factors with statistical differences between groups to determine the independent risk factors for the failure of H.pylori eradication.Results: The eradication rates of H.pylori in groups A,B,C and D were 91.7%,92.8%,90.2%,and 93.7%,respectively,with no significant difference(P >0.05).The incidence of adverse reactions in each group was8.1%,6.6%,3.7%,and 2.1%,among which group A was higher than group C(P<0.05),and group B was higher than group D(P<0.05).The costeffectiveness ratios of each group were 6.01,5.96,10.94,and 10.55,respectively,and the cost-effectiveness ratio of group B was the lowest.Univariate analysis showed that gender,age,marital status,history of antibiotic abuse,and family history of gastric disease were significantly different between successful and unsuccessful eradication groups.Multivariate analysis showed that males(OR 2.451,95%CI 1.655-3.629,P<0.001),age ≥45 years(OR 1.585,95%CI 1.063-2.3649,P=0.024),and a history of antibiotic abuse(OR 2.728,95)%CI 1.802-4.130,P<0.001)was an independent risk factor for H.pylori eradication failure.Conclusion: There was no significant difference in the eradication rate of H.pylori,and the incidence of adverse drug reactions between the bismuth quadruple regimen of doxycycline + furazolidone and doxycycline+ amoxicillin.The addition of Saccharomyces boulardii can not significantly improve the eradication rate of H.pylori,but can reduce the incidence of adverse drug reactions.The bismuth quadruple regimen of doxycycline + amoxicillin has the lowest cost-effectiveness ratio.Male gender,age ≥45 years,and a history of antibiotic abuse were independent risk factors for H.pylori eradication failure.There are 7 tables and 77 references.