Efficacy Anialysis Of Different Radical Treatment Programs For Helicobacter Pylori Infection In Yanbian Area

Objective:Analyze the clinical effectiveness and adverse effects of different programs in the eradication of Helicobacter pylori（H.pylori）infection in Yanbian area,and provide a reference for selecting effective treatment programs to eradicate H.pylori infection in Yanbian area in the future.Methods:This study adopts a prospective research method.A total of 269 patients who were diagnosed with H.pylori positive by ¹³C/¹⁴C ureatest or rapid urease test under gastroscopy were selected from December 2019 to October 2020 in the outpatient department of Gastroenterology Department of Yanbian University Hospital.People,including 137 males and 132 females,were divided into 5 groups and 12 cases were lost to follow-up.Patients without penicillin allergy for the first treatment were randomly divided into 2 groups,using different PPIs:Group A:Ilaprazole 5mg+Bismuth potassium citrate 220mg+Furazolidone 100mg+Amoxicillin 1.0g,bid;Group B:Rabeprazole 10mg+Bismuth potassium citrate 220mg+Furazolidone 100mg+Amoxicillin 1.0g,bid.Group C was the initial treatment for patients with penicillin allergy:Rabeprazole 10 mg+Bismuth potassium citrate 220 mg+Furazolidone 100 mg bid,+Tetracycline 500 mg tid.The treatment course of groups A,B,and C was 14 days.In group D,the regimen of group B was the same as that in group B,followed by the addition of 240 mg Jinghua Weikang capsules,bid,for a course of 30 days.The E group（non initial treatment and no penicillin allergy group）adopts the same plan as the B group.The initial treatment group is the first treatment patients,and the non-initial treatment group is the patients who have failed to eradicate Helicobacter pylori and stopped the drug for at least 6 months.Return to the hospital for follow-up 4 weeks after treatment but no later than 6 months.The eradication rate of each group was observed,and the negative¹³C/¹⁴C urea breath test was regarded as successful eradication of H.pylori.The remission rate of symptoms and adverse reactions were observed.Results:1.Basic patient data:There was no statistically significant difference in gender and age among the 5groups（P>0.05）.2.Eradication rate:The total eradication rate analyzed by ITT and PP is 88.10%（237/269[95%CI81%-92%]）and 92.22%（237/257[95%CI 91%-98%]）.According to ITT analysis,the eradication rates of the 5 programs were:Group A:89.53%（77/86[95%CI 83%-96%]）,Group B:91.78%（67/73[95%CI 85%-98%]）,Group C:88.57%（31/35[95%CI 77%-98%]）,Group D:87.18%（34/39[95%CI 73%-96%]）,Group E:77.78%（28/36[95%CI 51%-87%]）（P>0.05 between groups）.PP analysis is group A:93.90%（77/82[95%CI 89%-99%]）,group B:95.71%（67/70[95%CI91%-100%]）,group C:91.18%（31/34[95%CI 76%-98%]）,group D:94.44%（34/36[95%CI81%-99%]）,group E:80.00%（28/35[95%CI 63%-92%]）（P>0.05 between groups）.Among 257patients,the eradication rate was 94.14%（209/222）in the initial treatment,and 80.00%（28/35）in the non-initial treatment patients.The difference was statistically significant（P<0.05）.3.Incidence rate of adverse reactions:The overall adverse reaction rate was 6.23%（16/257）,among which fever was the most common treatment-related adverse event.There was no significant difference in the adverse reaction rate among the 5 groups（P>0.05）.4.Symptom relief rate:The total symptom relief rate was 90.66%（233/257）,and there was no statistically significant difference in t＿x0010＿of patients who successfully eradicated H.pylori was99.14%（231/233）and 25%（6/24）without successful eradication,（P<0.001）.Conclusions:1.When eradicating H.pylori in Yanbian area,regardless of whether the patient is newly treated,patients without penicillin allergy should choose the treatment plan of furazolidone combined with amoxicillin,and there is no serious adverse reaction,it can be used as a first-line eradication and remedial treatment.2.For patients allergic to penicillin,the use of furazolidone combined with tetracycline also achieved a satisfactory eradication rate.3.Ilaprazole and Rabeprazole have achieved similar eradication rates,and clinicians can choose the appropriate PPI.4.Adding Jinghua Weikang capsules can improve the symptom relief rate of patients,but it may not be statistically significant due to the small sample size.