| Objective:To compare the efficacy, safety, economy and the control of clinical symptoms of Colloidal bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori) eradication in a randomized, comparative clinical trial. The aim is to find out an effective therapy for patients with H. pylori infection.Methods:92 Patients with H.pylori-positive peptic ulcer disease or chronic gastritis diagnosed by endoscopy were randomly allocated to Group A and Group B. Patients in Group A received rabeprazole l0mg, colloidal bismuth pectin 150mg, amoxycillin 1.0g and clarithromycin 0.5g twice daily for 10 days. Patients in Group B received rabeprazole 10mg and amoxycillin 1.0g twice daily for the first 5 days; followed by rabeprazole 10mg, clarithromycin 0.5g and tinidazole 0.5g twice daily for the remaining 5 days. The adverse effects and the control of clinical symptoms were recorded during the course of treatment. After finishing of H. pylori therapy at least four weeks later, and after withdrawal of rabeprazole at least two weeks later, we compared the eradication of H. pylori by rapid urease test or 14C-urea breath test.Results:1. H. pylori was eradicated in 89.1% of group A VS 87.0% of group B for ITT, and 93.2% of group A VS 90.9% of group B for PP. No significant differences in both ITT and PP eradication rates were found between A and B groups (P>0.05).2. The adverse reaction rates and the clinical symptom remission rates were not significantly different between A and B groups (p>0.05).3. The cost effectiveness analysis showed that the C/E value of B group was lower than A group.Conclusion:Colloidal bismuth pectin quadruple and sequential therapies can both achieve high eradication rates, but sequential therapy which has the lower cost-effectiveness ratio is better than Colloidal bismuth pectin quadruple therapy in the initial treatment of H. pylori infection. |
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