The Clinical Efficacy Evaluation Of Modified Hybrid Therapy To Eradicate Helicobacter Pylori(H.pylori)

Objective:To study the clinical efficacy and safety of modified Hybrid therapy to eradicate Helicobacter pylori.Methods:From January 2017 to April 2018,one hundred and twenty patients whom were with confirmed H.pylori infection in department of gastroenterology in Affiliated Hospital of Chengdu University of Traditional Chinese Medicine were randomly assigned to receive a 14-d course of modified hybrid（group A,n=62）therapy or bismuth-based quadruple therapy（group B,n=58）.The group A received 40 mg esomeprazole and 1 g amoxicillin twice daily for 7 d,followed by 40 mg esomeprazole,1 g amoxicillin,0.1 g furazolidone,50 ml Houpo liquid twice daily for 7 d.The group B received 40 mg esomeprazole,1 g amoxicillin,0.1 furazolidone,200 mg colloidal bismuth pectin twice daily14 d.Follow-up results once a week to understand the patients compliance,clinical symptoms and adverse changes.Within one week after the treatment,upper G.I.endoscopy and serum pepsinogens test were prescribed to see the endoscopic remissions and the serum changes.Four weeks later after completion of the treatment,eradication efficacy was assessed by followed-up ¹³Urea breath test.Blood cell examination、biochemistry examination were routinely required pre-and post-treatment.Results:All the patients had completed the study.（1）The eradication rate was 95.16%for the group A and 91.38%for the group B.The findings of the study showed a higher eradication rate in group A than group B,and demonstrated no significant difference among them（P<0.05）.（2）The clinical symptom scores decreased pre-and post-treatment with a significant difference,respectively in two groups（P<0.05）.After the treatment,the symptom scores of group A,such as abdominal pain,epigastric distention,anorexia decreased compared with the ones of group B and a significant statistical change was found between two groups（P<0.05）.No significant difference was found between two groups with total clinical symptom scores after the treatment（P>0.05）.（3）The endoscopic scores decreased pre-and post-treatment with a significant difference,respectively in two groups（P<0.05）.After the treatment,the endoscopic scores of group A,such as mucosal swelling decreased compared with the ones of group B and a significant difference was found between two groups（P<0.05）.No significant difference was found between two groups with total endoscopic scores after the treatment（P>0.05）.（4）The serum pepsinogen A decreased pre-and post-treatment with a significant difference,respectively in two groups（P<0.05）.The serum pepsinogen C decreased pre-and post-treatment in two groups,a significant difference was found in group A（P<0.05）,no significant difference was found in group B（P>0.05）.No significant difference was found between two groups with the changes in serum parameters（P>0.05）.（5）The incidences of adverse events in group A and group B were 14.5%（9）and 29.3%（17）,respectively.The overall rate of adverse effects of group A was lower than that of group B with a significant difference（P<0.05）.All of the patients complied with the eradication therapies under appropriate administrations.Conclusion:Due to successful rate for HP eradication,excellent compliance,lower side effects,modified hybrid therapy seems to be an appropriate eradication regimen in clinical application,Especially good at releasing clinical symptoms and improving the gastritis.