Efficacy Analysis Of High Dose Dual Therapy For The Treatment Of Helicobacter Pylori Infection

Objectives:To assess the efficacy and safety of high-dose dual therapy(HDDT)versus bismuth quadruple therapy(BQT)for the treatment of Helicobacter pylori infection in the Suining area and initially explore the factors that influence the eradication rate.Methods:Patients with Helicobacter pylori infection were included and divided into HDDT group(esomeprazole magnesium enteric-coated tablet 40 mg twice daily and amoxicillin capsule 750 mg four times daily for 2 weeks)and BQT group(rabeprazole sodium enteric-coated tablet 10mg,colloidal pectin bismuth capsule 200mg,amoxicillin capsule 1000mg and metronidazole tablets 400mg,all given twice daily for 2 weeks)according to the treatment regimen.C14 urea breath test(C14-UBT)was performed one month after the completion of treatment.Effectiveness and side effects of both groups were compared.Results:In all,2126 patients were initially treated,and 520 patients were included after excluding patients without retest results,incomplete clinical data,and irregular medication,including 284 in the HDDT group and 236 in the BQT group.A total of 223 pairs of patients were successfully matched by propensity score matching(PSM).The eradication rates of HDDT and BQT were 74.4%and 77.1%(P=0.507),respectively.The incidence of side effects for the HDDT regimen and the BQT regimen was 8.5%and 23.8%(P<0.001),respectively.In the HDDT regimen,age≥ 50 years old increased the risk of eradication failure(OR=1.927,95%CI:1.035-3.586,P=0.038),and BMI≥ 24 increased the risk of eradication failure(OR=2.036,95%CI:1.056-3.927,P=0.034).Conclusion:The eradication rates of both HDDT and BQT for the treatment of HP infection are similar in the Suining area,but the former has fewer side effects.Patients aged>50 years and BMI>24 are independent risk factors for eradication failure in HDDT.