Clinical efficacy of different doses of esomeprazole based quadruple therapy on 248 cases of Helicobacter pylori caused gastritis in Uygur
10.3760/cma.j.issn.0254-1432.2017.03.010
- VernacularTitle:不同剂量艾司奥美拉唑镁为基础的四联方案治疗248例维吾尔族幽门螺杆菌性胃炎的疗效观察
- Author:
Wen YU
;
Qi ZHU
- Keywords:
Helicobacter pylori gastritis;
Dyspepsia;
Quadruple therapy;
Esomeprazole;
Uygur nationality
- From:
Chinese Journal of Digestion
2017;37(3):172-178
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy of different doses of esomeprazole based quadruple therapy on Helicobacter pylori(H.pylori) eradication in Uygur population, and to study the relationship between H.pylori eradication and dyspepsia symptoms in H.pylori caused gastritis.Methods From August 2015 to May 2016, Uygur patients diagnosed with H.pylori positive superficial gastritis in Xinjiang Uygur Autonomous Region Kashgar Prefecture were recruited.According to random number table, patients were divided into single-dose group, standard-dose group and high-dose group.In single-dose group patients received esomeprazole 40 mg, once per day;in standard-dose group patients received esomeprazole 20 mg, twice per day;and in high-dose group patients received esomeprazole 40 mg, twice per day;besides esomeprazole the treatment of three groups were all combination of amoxicillin, clarithromycin and bismuth, magnesium compound granules.The treatment course of all three groups was 14 days.The H.pylori eradication rate, clinical efficacy, symptom score and adverse drug reaction were compared.The H.pylori eradication rate was evaluated with intention to treat analysis (ITT) and per-protocol sets (PP).Chi square test, t test and one-way analysis of vaiance were used for statistical comparison.Results A total of 248 patients were enrolled,82 cases in single-dose group, 83 cases in standard-dose group and 83 cases in high-dose group.There were five, five and six cases lose to follow-up or dropped out respectively in single-dose, standard-dose and high-dose group.The results of ITT analysis showed that the eradication rates of H.pylori in single-dose group, standard-dose group and high-dose group were 62.2%(51/82),77.1%(64/83) and 89.2%(74/83),respectively;the differences between each two groups were statistically significant (x2=4.34,16.33 and 4.30, all P<0.05).The results of PP analysis showed that H.pylori eradication rates of single-dose group, standard-dose group and high dose group were 66.2%(51/77),82.1%(64/78) and 96.1%(74/77),respectively;the differences between each two groups were statistically significant (x2=5.06, 22.47 and 7.84, all P<0.05).After four weeks of eradication therapy, the total dyspepsia symptom scores of single-dose group, standard-dose group and high dose group were all significantly lower than those before treatment (52.3±27.1 vs 99.4±44.1, 38.2±25.4 vs 101.0±48.9 and 28.8±16.1 vs 99.9±46.6), and the differences were statistically significant(t=5.88, 8.79 and 9.11, all P<0.01).After treatment, the total dyspepsia symptom scores of standard-dose group and high-dose group were both lower than that of single-dose group, and the differences were statistically significant (t=2.78 and 2.91, both P<0.01).The score of upper abdominal pain, epigastric burning, abdominal distention and symptom total score of high-dose group were all lower than those of standard dose group (4.8±3.9 vs 8.1±3.5, 3.1±2.5 vs 5.8±4.1, 7.9±6.8 vs 10.5±9.6 and 28.8±16.1 vs 38.2±25.4), and the differences were statistically significant (t=1.52,1.08,1.23 and 1.96, all P<0.01).After four weeks of treatment, the total efficacy rates of single-dose, standard-dose and high-dose group were 45.5%(35/77), 74.4%(58/78) and 87.0%(67/77),respectively.There were statistically significant differences between each two groups of three groups (x2=13.49, 29.73 and 3.98, all P<0.05).The incidences of adverse drug reaction of single-dose, standard-dose and high-dose group were 6.5%(5/77), 7.7%(6/78) and 7.8%(6/77),respectively;there was no statistically significant difference among the three groups (all P>0.05).Conclusions High dose of esomeprazole based quadruple therapy can increase the eradication rate of H.pylori in Uygur population, and H.pylori eradication therapy can significantly improve the dyspepsia symptoms of H.pylori caused gastritis in Uygur.High dose of esomeprazole may improve the clinical efficacy of H.pylori caused gastritis with dyspeptic symptoms in Uygur with safety.
