Clinical Research on Triple Therapy Containing Levofloxacin for First-line Helicobacter Pylori Eradication Treatment_West China Medical Journal

Authors：

TAN Lirang ¹ , LI Hu ¹ , JIN Jun ¹ ,  WU Longfei ²

1. Department of Gastroenterology; 2. Department of Critical Care Medicine, Bazhong Central Hospital, Bazhong, Sichuan 636000, P. R. China;

Corresponding?author：

WU Longfei, Email: 1271092104@qq.com

Keywords：

左氧氟沙星; 三聯療法; 幽門螺桿菌

Video：

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目的　探討含左氧氟沙星的三聯療法作為一線方案對幽門螺桿菌感染治療的有效性和安全性。方法　選擇2008年9月－2011年3月125例確診為幽門螺桿菌感染的初治患者，隨機分為雷貝拉唑、阿莫西林聯合左氧氟沙星組（A組）和雷貝拉唑、阿莫西林聯合克拉霉素組（B組），經治療7 d后比較兩組根除率和不良反應發生率。結果　A、B組幽門螺桿菌符合方案分析根除率分別為91.8%、77.6%，意向性治療根除率分別為88.9%、72.6%，A組根除率高于B組，差異有統計學意義（P＜0.05）。A、B組不良反應發生率分別為4.8%、3.2%（P＞0.05）。結論　以左氧氟沙星、阿莫西林、雷貝拉唑為組合的三聯療法能顯著提高幽門螺桿菌感染的初治成功率，不良反應少，安全有效。

Citation： TAN Lirang,LI Hu,JIN Jun,WU Longfei. Clinical Research on Triple Therapy Containing Levofloxacin for First-line Helicobacter Pylori Eradication Treatment. West China Medical Journal, 2012, 27(3): 329-331. doi: Copy

1.	中華醫學會消化病學分會幽門螺桿菌學組. 第三次全國幽門螺桿菌感染若干問題共識報告(2007年8月·廬山)[J]. 中華內科雜志, 2008, 47(4): 346-349.
2.	Lind T, Veldhuyzen van Zanten S, Unge P, et al. Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: the MACH I Study[J]. Helicobacter, 1996, 1(3): 138-144.
3.	成虹, 胡伏蓮, 謝勇,等. 中國幽門螺桿菌耐藥狀況以及耐藥對治療的影響——全國多中心臨床研究[J]. 胃腸病學, 2007, 12(9): 525-530.
4.	Saad RJ, Schoenfeld P, Kim HM, et al. Levofloxacin-based triple therapy versus bismuth-based quadruple therapy for persistent Helicobacter pylori infection: a meta-analysis[J]. Am J Gastroenterol, 2006, 101(3): 488-496.
5.	Gisbert JP, Morena F. Systematic review and meta-analysis: levofloxacin-based rescue regimens after Helicobacter pylori treatment failure[J]. Aliment Pharmacol Ther, 2006, 23(1): 35-44.
6.	Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report[J]. Gut, 2007, 56(6): 772-781.
7.	成虹, 胡伏蓮, 李江. 幽門螺桿菌耐藥性對其根除治療影響的研究[J]. 中華醫學雜志, 2006, 86(38): 2679-2682.
8.	牟方宏, 胡伏蓮楊桂彬,等. 質子泵抑制劑四聯療法作為幽門螺桿菌根除治療一線方案的臨床研究[J]. 胃腸病學, 2007, 12(9): 531-534.
9.	De Francesco V, Margiotta M, Zullo A, et al. Prevalence of primary clarithromycin resistance in Helicobacter pylori strains over a 15 year period in Italy[J]. J Antimicrob Chemother, 2007, 59(4): 783-785.
10.	Mégraud F. H pylori antibiotic resistance: prevalence, importance, and advances in testing[J]. Gut, 2004, 53(9): 1374-1384.
11.	Mégraud F. Update on Therapeutic Options for Helicobacter Pylori-related Diseases[J]. Curr Infect Dis Rep, 2005, 7(2): 115-120.
12.	鄒軍, 楊昭徐, 覃卓明. 左旋氧氟沙星抗幽門螺桿菌的實驗室評價和臨床研究[J]. 中華醫學雜志, 2003, 83(20): 178-181.
13.	袁媛, 于靜, 賈長河. 含左氧氟沙星的一線方案根除幽門螺桿菌療效分析[J]. 山東醫藥, 2009, 49(52): 96-97.
14.	Cammarota G, Cianci R, Cannizzaro O, et al. Efficacy of two one-week rabeprazole/levofloxacin-based triple therapies for Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2000, 14(10): 1339-1343.
15.	Di Caro S, Zocco MA, Cremonini F, et al. Levofloxacin based regimens for the eradication of Helicobacter pylori[J]. Eur J Gastroenterol Hepatol, 2002, 14(12): 1309-1312.
16.	Graham DY, Lu H, Yamaoka Y. A report card to grade Helicobacter pylori therapy[J]. Helicobacter, 2007, 12(4): 275-278.
17.	成虹, 胡伏蓮, 張國新, 等. 含左氧氟沙星三聯療法一線治療幽門螺桿菌感染: 多中心隨機對照臨床研究[J]. 中華醫學雜志, 2010, 90(2): 79-82.
18.	李虎, 譚禮讓, 何濱岑, 等. 含鉍劑四聯療法作為一線方案根治幽門螺桿菌感染的臨床研究[J]. 華西醫學, 2011, 26(10): 1488-1490.

1. 　中華醫學會消化病學分會幽門螺桿菌學組. 第三次全國幽門螺桿菌感染若干問題共識報告(2007年8月·廬山)[J]. 中華內科雜志, 2008, 47(4): 346-349.
2. 　Lind T, Veldhuyzen van Zanten S, Unge P, et al. Eradication of Helicobacter pylori using one-week triple therapies combining omeprazole with two antimicrobials: the MACH I Study[J]. Helicobacter, 1996, 1(3): 138-144.
3. 　成虹, 胡伏蓮, 謝勇,等. 中國幽門螺桿菌耐藥狀況以及耐藥對治療的影響——全國多中心臨床研究[J]. 胃腸病學, 2007, 12(9): 525-530.
4. 　Saad RJ, Schoenfeld P, Kim HM, et al. Levofloxacin-based triple therapy versus bismuth-based quadruple therapy for persistent Helicobacter pylori infection: a meta-analysis[J]. Am J Gastroenterol, 2006, 101(3): 488-496.
5. 　Gisbert JP, Morena F. Systematic review and meta-analysis: levofloxacin-based rescue regimens after Helicobacter pylori treatment failure[J]. Aliment Pharmacol Ther, 2006, 23(1): 35-44.
6. 　Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report[J]. Gut, 2007, 56(6): 772-781.
7. 　成虹, 胡伏蓮, 李江. 幽門螺桿菌耐藥性對其根除治療影響的研究[J]. 中華醫學雜志, 2006, 86(38): 2679-2682.
8. 　牟方宏, 胡伏蓮楊桂彬,等. 質子泵抑制劑四聯療法作為幽門螺桿菌根除治療一線方案的臨床研究[J]. 胃腸病學, 2007, 12(9): 531-534.
9. 　De Francesco V, Margiotta M, Zullo A, et al. Prevalence of primary clarithromycin resistance in Helicobacter pylori strains over a 15 year period in Italy[J]. J Antimicrob Chemother, 2007, 59(4): 783-785.
10. 　Mégraud F. H pylori antibiotic resistance: prevalence, importance, and advances in testing[J]. Gut, 2004, 53(9): 1374-1384.
11. 　Mégraud F. Update on Therapeutic Options for Helicobacter Pylori-related Diseases[J]. Curr Infect Dis Rep, 2005, 7(2): 115-120.
12. 　鄒軍, 楊昭徐, 覃卓明. 左旋氧氟沙星抗幽門螺桿菌的實驗室評價和臨床研究[J]. 中華醫學雜志, 2003, 83(20): 178-181.
13. 　袁媛, 于靜, 賈長河. 含左氧氟沙星的一線方案根除幽門螺桿菌療效分析[J]. 山東醫藥, 2009, 49(52): 96-97.
14. 　Cammarota G, Cianci R, Cannizzaro O, et al. Efficacy of two one-week rabeprazole/levofloxacin-based triple therapies for Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2000, 14(10): 1339-1343.
15. 　Di Caro S, Zocco MA, Cremonini F, et al. Levofloxacin based regimens for the eradication of Helicobacter pylori[J]. Eur J Gastroenterol Hepatol, 2002, 14(12): 1309-1312.
16. 　Graham DY, Lu H, Yamaoka Y. A report card to grade Helicobacter pylori therapy[J]. Helicobacter, 2007, 12(4): 275-278.
17. 　成虹, 胡伏蓮, 張國新, 等. 含左氧氟沙星三聯療法一線治療幽門螺桿菌感染: 多中心隨機對照臨床研究[J]. 中華醫學雜志, 2010, 90(2): 79-82.
18. 　李虎, 譚禮讓, 何濱岑, 等. 含鉍劑四聯療法作為一線方案根治幽門螺桿菌感染的臨床研究[J]. 華西醫學, 2011, 26(10): 1488-1490.

West China Medical Journal

Clinical Research on Triple Therapy Containing Levofloxacin for First-line Helicobacter Pylori Eradication Treatment

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