The Efficay Observation Of The10-day、14-day Sequential Therapy And Bismuth Quadruple Therapy In Remedy Of Helicobacter Plori After Initial Treament Failure

Objiective To Observe the efficacy、 patient’s symptoms、drug of security and adverseeffects based on10days sequential therapy、14days sequential therapy and10daysquadruple therapy as rescue therapy after a failed first-line eradication H.Pylori. andthree groups of treatment programs cost-effectiveness analysis, then to find aclinically safe and effective, relatively inexpensive and readily accepted by patientsremedial treatment.Methods Patients who were H. pylori positive through14C-urea breath test, diagnosedwith peptic ulcer or chronic gastritis in endoscopy clinic，and and all patients afterreceived regular anti Hp therapy,91patients Were randomly divided into three groups.Group A (n=30, male18, female12) bismuth quadruple therapy: containing rabeprazole10mg bid，colloidal bismuth pectin0.15g tid，amoxicillin0.457g bid， levofloxacin0.2gbid,10days for a course; group B (n=30patients, male17, female13)10-daysequential therapy: rabeprazole10mg bid plus amoxicillin0.457g bid for the first5days,the remaining5days by rabeprazole， levofloxacin200mg bid and Tinidazole0.5gbid; C group (n=31, male19, female12)14days sequential therapy: rabeprazole10mgbid plus amoxicillin0.457g bid for the first7days, followed by rabeprazole, levofloxacin0.2g bid, bid, Tinidazole0.5g bid for the next7days. Record adverse conditions andsymptoms relieve the situation of the patients during the treatment, appointment time tostop using antibiotics for at least1month, stop using PPI at least14days after14c-Ureabreath Test (Urea Breanth Test, UBT) detection of Hp eradication.Results in this experiment, a total of91patients, three groups of each1case was lost tofollow-up, patients without severe adverse reaction (ADR) and withdraw from the experiment.10days of bismuth quadruple group,10-day sequential therapy group and14-day sequential regimen group were30cases,30cases and31cases. Three groups of Hperadication rate according to the intention to treat analysis (ITT) eradication rates were73.3%,76.7%and80.6%; Complete treatment analysis (PP) eradication rate were75.9%,79.3%and759%respectively; Between the three groups of eradication rate there was nosignificant difference in statistical significance (P>0.05); Three different treatment ofsymptom remission rate and incidence of adverse reactions are no significant difference(P>0.05); Cost-effectiveness analysis showed that each additional eradication rate1%,10days of bismuth quadruple therapy more than10-day sequential therapy of high cost33.5yuan,10day sequential therapy less than14day sequential therapy low cost14.13yuan.Conclusion10days sequential therapy,14days sequential therapy,10days of bismuthquadruple therapy for Hp remedial treatment,14-day sequential therapy of eradicationrate is relatively high, but no statistical difference between three groups (P>0.05).Probably the small sample size of the study, as well as the limitations in our hospitalpatients, and the region of antibiotic resistance and so on. so need a large sample,multi-center, randomized experiments to prove it. Three groups of no statisticaldifference between the incidence of adverse reactions (P>0.05), and suggests threekinds of scheme has good security.10days sequential therapy as Hp eradication ofsecond-line remedial treatment more economical, easy to be accepted by the patients, isworth popularizing in clinic.