J Gastroenterol Hepatol:反向混合疗法和同步疗法在幽门螺杆菌感染的一线治疗中疗效相当

2021-07-24 MedSci原创 MedSci原创

在大多数国家或国际共识中,同步治疗是幽门螺旋杆菌感染的推荐一线治疗方法。反向混合疗法是一种改良的14天伴随疗法,在最后7天没有克拉霉素和甲硝唑。本研究旨在检验14天反向混合疗法在幽门螺杆菌感染的一线治

在大多数国家或国际共识中,同步治疗是幽门螺旋杆菌感染的推荐一线治疗方法。反向混合疗法是一种改良的14天伴随疗法,在最后7天没有克拉霉素和甲硝唑。本研究旨在检验14天反向混合疗法在幽门螺杆菌感染的一线治疗中是否不逊于14天的同步疗法,研究结果已发表于J Gastroenterol Hepatol。

将幽门螺杆菌感染的成年患者随机分配至反向混合疗法(右兰索拉唑60毫克o.d.加阿莫西林1克b.d.,持续14天,以及克拉霉素500毫克加甲硝唑500毫克b。 d.最初7天)和同步治疗(右兰索拉唑60毫克,每天一次,加阿莫西林1克,克拉霉素500毫克,甲硝唑500毫克,每天两次,共14天)。治疗结束后6周对幽门螺杆菌状况进行了评估。

 

结果,248名幽门螺杆菌感染者接受14天的反向混合疗法(n = 124),1248名幽门螺杆菌感染者接受同步疗法。意向治疗分析表明,两种疗法的根除率相当(95.2% vs 93.5%;95%置信区间,-4.0%至7.4%;P = 0.582)。然而,反向混合疗法的不良事件发生频率远低于同步疗法(20.2% vs 38.7%,P = 0.001)。两种疗法表现出相当的药物依从性(93.5% vs 87.9%,P = 0.125)。

综上,该研究结果表明,14天的反向混合疗法和14天的同步疗法在幽门螺杆菌感染的一线治疗中疗效相当。然而,与同步治疗相比,反向混合疗法的不良事件更少。

 

原始出处:

 

Ping-I Hsu, et al., Equivalent efficacies of reverse hybrid and concomitant therapies in first-line treatment of Helicobacter pylori infection. J Gastroenterol Hepatol. 2020 Oct;35(10):1731-1737. doi: 10.1111/jgh.15034.  

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    2022-06-25 许安
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    2021-07-25 gwc384
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    2021-12-13 kcb069
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    2021-07-24 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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