Eradication Therapy For Helicobacter Pylori Infection In Patients With Duodenal Uclers Based On Furazolidone Triple And Quadruple Therapy

Objectives：To evaluate the efficacy of furazolidone-based triple and quadrupletherapies in eradicating H. pylori. To view and compare the efficacy of7-days and10-days containning furazolidone tripletherapy to eradicate H.pylori; To view andcompare the clinical efficacy of7-days and10-days containing furazolidone andbismuth quadrupletherapy to eradicate H.pylori; To compare the eradication ratesbetween triple regimens and quadruple regimens; To compare remission of clinicalsymptoms, and the incidence of side effects.Subjects: We enrolled357outpatients from June1st2010to December31st2010at the First Affiliated Hospital of Nanchang University, who had been diagnosedduodenal ulcer (DU) through gastroscopy inspection and H. pylori infection throughrapid urease test(RUT). Complaints had epigasteium pain, bloating, acid reflux,heartburn.Methods：357patients were randomly assigned to four treatment groups(A-D):patients in Group A and Group B, received rabeprazole10mg, amoxicillin1000g and furazolidone100mg, twice daily for7and10days, respectively. Patientsin Group C and Group D received rabeprazole10mg, bismuth220mg, amoxicclin1000mg and furazolidone100mg, twice daily for7and10days, respectively. Afterthe end of7days or10days, rabeprazole10mg was given once daily for two weeksin all groups. H. pylori status was re-assessed with the14C-urea breath test (UBT)4weeks after the end of therapy.Results: The patients included a total of357cases in the study,323cases completedthe study. Thrity-four patients discontinued, ten cases were lost, eight cases exited dueto adverse events, and two cases were terminated due to the combined use ofantibiotics, one case required to withdraw, one case exited due to pregnancy, and onecase was withdrawn for the discovery of liver lesions, lost out of the number of casesaccounted for9.52%.1. The comparison of gender, age among A，B，C，D four groups： Among the four groups，there wre no significantly differences in gender, age(P>0.05).2. The comparison of the eradication rate among the groups:According to the analysis of ITT, the Hp-eradication rates in Group A to D,were71.91%,78.4%，81.32%，83.15%, respectively；There was nonsignficantdeviation among all groups (P>0.05). According to the analysis of PP, H.pylorieradication rates in the A to D, were78.05%,88.09%,87.34%,94.87%,respectively. There was signficant deviation among all groups (P=0.017), H.pylorieradication rate in group D was significantly higher than that in group A (P=0.002).3. The comparison of clinical symptom relief rates among all groups:There wre no significantly difference in clinical symptom relief rates among allgroups (P>0.05).4. The comparison of the adverse events among all groups:The total adverse reaction rate was7%，there were no significant differenceamong all groups (P>0.05).Conclusions:1. Containning furazolidone, bismuth quadruple treatments provide higher H.pylori eradication rates than triple therapies. The eradication rates were as follows:quadruple10days> triple10days> quadruple7days> triple7days, promptingextended regimens and increased bismuth agent can improve the H. pylori eradicationrate.2. There was no significant deviation in clinical symptom relief rates among allgroups.3. Adverse events were similar among all groups.