Helicobacter Pylori Infection Clinical Efficacy Of Four Scenarios Eradication Of

Objective: Comparative analysis of bismuth-containing quadruple therapy and 10-day sequential therapy, 14-day sequential therapy and levofloxacin-based quadruple therapy for patients infected with Hp Hp eradication effect,symptoms remission and cost- effectiveness analysis; analysis of the patient’s general situation(gender, age, smoking history, alcohol history and spicy food) relationship with Hp infection.Subjects and Methods: elected to the patient in June 2013-2014 June Yan’an University Affiliated Hospital Gastroenterology clinic, by endoscopy and 14C-UBT diagnosed as chronic gastritis combined with Hp positive in 125 cases(of which 2 cases Serious adverse reactions to withdraw from this study, 11 cases were excluded because of lost), the average age of 42.5 ± 9.8(19-63 years old), male 63 cases, female 62 cases, the patients were eligible for inclusion, exclusion criteria by the investigation. The main clinical symptoms: abdominal pain, bloating, belching, anorexia, nausea and acid reflux symptoms 6. According to the principle of randomization, random number table sampling method will study subjects were randomly divided into four groups, specific programs and courses are as follows: A group(bismuth-containing quadruple therapy group): rabeprazole sodium enteric-coated capsules + colloidal pectin bismuth particles + amoxicillin and clavulanate potassium tablet + clarithromycin extended release tablets, treatment 10d; group B(10d sequential therapy group): Before 5d: rabeprazole sodium enteric-coated capsules + amoxicillinclavulanic potassium tablet; after 5d: rabeprazole sodium enteric-coated capsules + tinidazole tablets+ clarithromycin extended release tablets, treatment 10d; group C(14d sequential therapy group): Before 7d: rabeprazole sodium enteric-coated capsules + amoxicillin and clavulanate potassium tablet; after 7d: rabeprazole sodium enteric-coated capsules + tinidazole tablets +clarithromycin extended release tablets, treatment 14d; D group(levofloxacin therapy group): rabeprazole sodium enteric-coated capsules + levofloxacin + amoxicillin and clavulanate potassium tablet + colloidal bismuth pectin particles, treatment 10 d. Medication: wherein rabeprazole 10 mg bid morning and evening; colloidal bismuth pectin particles 0.15 g qid were half an hour before meals and before bed; amoxicillin and clavulanate potassium 914 mg bid after meal; clarithromycin 0.5g bid after meals; tinidazole 0.5g bid after meals; levofloxacin 0.2g bid after meal. 4 weeks after the end of treatment, review of 14C-UBT checks clear Hp eradication rate, efficiency, incidence of adverse reactions, cost- effectiveness analysis.The results: 1. Comparison of four groups of four groups of patients with Hp patients with general information of sex, age, smoking history, alcohol and spicy food history showed no significant difference(P> 0.05). 2.Comparison of the clinical efficacy of the four groups A group of four groups(bismuth-containing quadruple therapy group), group B(10d sequential therapy group) and group C(14d sequential therapy group), the difference was not statistically significant effect(P> 0.05); D group(levofloxacin therapy group) were higher than the efficacy of these three groups, the difference was statistically significant(P <0.05). 3.Comparison of the four groups Hp eradication rate Four groups Hp eradication rate between group A(bismuth-containing quadruple therapy group), group B(10d sequential therapy group) and group C(14d sequential therapy group), the difference was not statistically significant effect(P> 0.05); D group(levofloxacin therapy group) Hp were higher than three groups, the difference was statistically significant(P <0.05). 4.General information on the impact of Hp General information on the Hp of the effects of gender, age, smoking history and spicy diet eradicate no significant effect(P> 0.05) for Hp; drinking history had a significant impact on Hp eradication(P <0.05), non-drinkers Hp eradication was significantly higher than the occasional drinking and frequent drinkers. 5.The incidence of adverse reactions were compared four groups of patients The incidence of adverse reactions in patients four groups was not statistically significant(P> 0.05). 6.The four programs cost-effectiveness analysis Cost A, B, C, D four programs are:509.63 yuan, 272.88 yuan, 382.03 yuan, 393.96 yuan; its effects are as follows: 59.26%, 65.52%, 70.83%, 96.88%.In conclusion 1. Eligible patients’ gender, age, smoking history, drinking history and spicy comparability between diet; 2. Bismuth-containing quadruple therapy group, 10 d and 14 d sequential therapy group sequential therapy group, which has a low efficiency, the effective rate of levofloxacin therapy group; 3. bismuth-containing quadruple therapy group, 10 d sequential therapy group, 14 d sequential therapy, the Hp eradication rate, are not up to standard,. the Levofloxacin therapy group Hp eradication rate, to eradicate standard; 4. containing bismuth quadruple therapy group, 10 d and 14 d sequential therapy group sequential therapy group effectiveness and Hp eradication rate was no significant difference; 5. levofloxacin therapy group effectiveness and Hp eradication rate in bismuth-containing quadruple group, 10 d and 14 d sequential therapy Sequential therapy; 6. gender, age, smoking history and spicy food had no significant effect on the Hp eradication rate, drinking Hp eradication rate impact; 7. Bismuth-containing quadruple therapy group, 10 d sequential therapy group, 14 d sequential therapy group, levofloxacin therapy group, adverse reactions were no significant differences; 8. through cost-effectiveness analysis, that the four scenarios levofloxacin therapy is the best solution to eradicate Hp.