Effect Analysis On Eradication Of Helicobacter Pylori By Vonoprazan Combined With Standard Dose Amoxicillin

Background and Objective:Helicobacter pylori(Hp)infection is a common chronic bacterial infection in humans,infecting approximately 50% of the global population.Hp is a causative factor in a variety of diseases such as gastritis,peptic ulcer,gastric cancer,mucosa-associated lymphoid tissue lymphoma,and a causative factor in vitamin B12 deficiency,iron deficiency and idiopathic thrombocytopenia,and eradication of Hp is an important factor in the prevention and control of these diseases.With the increase in Hp resistance,the classical triple regimen has significantly reduced the eradication rate of Hp.Quadruple regimens containing bismuth have been recommended as first-line regimens for Hp eradication,but they suffer from a wide range of dosing options,long dosing times and poor compliance,which affects the eradication rate and reduces the range of antibiotic options available for remedial therapy once the first eradication has failed.In this paper,we compared vonoprazan with proton pump inhibitors(PPIs)as a new acid-suppressing drug,which has a longer duration of acid inhibition,less individual variation and can maintain a higher level of intragastric PH for a longer period of time,and the primary and secondary resistance of Hp to amoxicillin is lower,and increasing PH can improve the bactericidal effect of amoxicillin.In this paper,we compared the efficacy and adverse effects of vonoprazan combined with amoxicillin and quadruple therapy containing bismuth in the eradication of Hp,with a view to providing a new option for clinical eradication of Hp.Methods:Two hundred patients over 14 years of age who were diagnosed with Hp infection and treated for the first time at the First Central Hospital of Baoding were selected as the study subjects and randomly divided into experimental and control groups,with 100 cases in each group.The experimental group was given vonoprazan combined with amoxicillin(vonoprazan fumarate tablet 20 mg twice a day,amoxicillin capsule 1g twice a day for 7 days),while the control group was given a quadruple regimen containing bismuth(esomeprazole magnesium enteric solution tablet 20 mg twice a day,colloidal bismuth granules 300 mg twice a day,amoxicillin capsule 1g twice a day,clarithromycin tablet 500 mg twice a day for 14 days).(twice a day for 14 days).All patients were rechecked 4 weeks after completion of treatment with C-13 urea breath test(UBT),and the eradication rate and incidence of adverse effects in patients with different regimens were counted.Results:1.Out of 200 patients,12 patients failed to complete the treatment regimen.Among the 95 patients who completed clinical observation in the experimental group,84 of them successfully eradicated Hp,accounting for88.4%;among the 93 patients who completed clinical observation in the control group,86 of them successfully eradicated Hp,accounting for 92.5%.The difference between the ITT eradication rate and the PP eradication rate of Hp in the experimental group and the control group was not statistically significant(P > 0.05).2.3 patients in the experimental group had drug-related adverse reactions during the treatment process,the incidence of adverse reactions was 3.2%,while 12 patients in the control group had drug-related adverse reactions,the incidence of adverse reactions was 12.9%.When comparing the incidence of adverse reactions between the experimental group and the control group,the incidence of adverse reactions in the experimental group was significantly lower than that in the control group,and the difference was statistically significant(P < 0.05).3.The average cost of treatment for patients in the experimental group was134.10±11.35 RMB,while that for patients in the control group was184.21±16.65 RMB.The treatment cost in the experimental group was significantly lower than that in the control group,and the difference was statistically significant(P<0.01).Conclusion:1.vonoprazan combined with amoxicillin is not inferior to bismuth-containing quadruple regimen in Hp eradication treatment,and both regimens can effectively treat Hp infection.2.Vonoprazan in combination with amoxicillin has a lower incidence of adverse reactions than the bismuth-containing quadruple regimen with fewer dose types and shorter dosing times.3.The vonoprazan-amoxicillin regimen was less costly than the bismuth-containing quadruple regimen.