Clinical Study Of Fourfold Therapy With Vonoprazan Fumarate In The Treatment Of Helicobacter Pylori

Objective: Helicobacter pylori(Hp)infection is a common chronic infectious diseases,the early symptoms are not obvious,but with the development of time,it is easy to cause chronic gastritis and peptic ulcer and other diseases,which is also a risk factor to induce gastric cancer,which needs early treatment.At present,quadruple therapy(proton pump inhibitors,two antibiotics,and one bismuth agent)is the standard treatment for Helicobacter pylori.However,proton pump inhibitors have a slow onset and only have inhibitory effects on active proton pumps,resulting in poor efficacy in Helicobacter pylori eradication treatment.Therefore,this study comprehensively evaluates the effectiveness and safety of the novel acid suppressant vorolaxen in the treatment of Helicobacter pylori infection by analyzing its eradication rate,incidence of adverse reactions,and improvement of gastrointestinal symptoms,providing clinical basis for the eradication of Helicobacter pylori.Method: For the first eradication treatment,214 patients who tested positive for 13 C urea breath test at the Gastroenterology Clinic of Yichun People’s Hospital from April2022 to December 2022 were selected and eligible for enrollment.Randomly divide214 subjects into an experimental group and a control group,with 107 cases in each group.The experimental group received oral administration of 20 mg of vorolaxone twice a day,1000 mg of amoxicillin twice a day,100 mg of furazolidone twice a day,and 600 mg of bismuth potassium citrate capsules twice a day;The control group received oral administration of 20 mg of Esomeprazole magnesium enteric coated capsules twice a day,1000 mg of amoxicillin twice a day,100 mg of furazolidone twice a day,and 600 mg of bismuth potassium citrate capsules twice a day.Both groups were treated for 14 days.49 patients who tested positive for 13 C urea breath test and had undergone radical treatment from April 2022 to January 2023 at the Gastroenterology Clinic of Yichun People’s Hospital were selected for remedial and eradication treatment.Randomly divide 49 subjects into an experimental group and a control group,with 25 in the experimental group and 24 in the control group.The experimental group received oral administration of 20 mg of vorolaxone twice a day,1000 mg of amoxicillin twice a day,100 mg of furazolidone twice a day,and 600 mg of bismuth potassium citrate capsules twice a day;The control group received 40 mg of esomeprazole magnesium enteric coated capsules twice a day,1000 mg of amoxicillin twice a day,100 mg of furazolidone twice a day,and 600 mg of bismuth potassium citrate capsules twice a day orally.Both groups were treated for 14 days.Both first-time treatment and remedial treatment patients underwent 13 C urea breath test 6-8 weeks after the end of medication to evaluate the eradication rate of Hp positive patients with two treatment regimens,and to compare the adverse reaction rate and improvement of gastrointestinal symptoms after treatment between the two groups.Result: For the first treatment,the Hp eradication rates of the vorolaxen group and the Esomeprazole magnesium enteric coated capsule group were 84.1% and 80.3%,respectively,according to intention-to-treat analysis,and 96.8% and 93.5%,respectively,according to protocol analysis.There was no statistically significant difference in eradication rates between the two groups(p>0.05);The incidence of adverse reactions in the vorolaxen group was 15.0%,while the incidence of adverse reactions in the Esomeprazole magnesium enteric coated capsule group was 26.2%.There was a statistically significant difference in the incidence of adverse reactions between the two groups(P<0.05);There were 54 cases of improvement in gastrointestinal symptoms after treatment in the Vonorasone group,and 43 cases in the Esomeprazole magnesium enteric coated capsule group.There was no statistically significant difference in the number of improvement in gastrointestinal symptoms between the two groups(p>0.05).Remedial treatment: The Hp eradication rates of the vorolaxen group and the Esomeprazole magnesium enteric coated capsule group were92.0% and 87.5% in intention-to-treat analysis,and 95.8% and 91.3% in protocol analysis,respectively.There was no statistically significant difference in eradication rates between the two groups(p>0.05);The incidence of adverse reactions in the vorolaxen group was 16.0%,while the incidence of adverse reactions in the Esomeprazole magnesium enteric coated capsule group was 21.0%.There was no statistically significant difference in the incidence of adverse reactions between the two groups(p>0.05);There were 12 cases of improvement in gastrointestinal symptoms after treatment in the Vonorasone group,and 10 cases in the Esomeprazole magnesium enteric coated capsule group.There was no statistically significant difference in the number of improvement in gastrointestinal symptoms between the two groups(p>0.05).Conclusion:1.The efficacy and safety of the four combinations of vorolaxen in the first treatment of Helicobacter pylori are not inferior to those of the four combinations of esomeprazole magnesium enteric coated capsules,and can be used as an effective treatment plan;Low incidence of adverse reactions and good tolerance;The vorolaxen group has an advantage in improving gastrointestinal symptoms.2.Vonorasone quadruple therapy can be used for salvage treatment of Helicobacter pylori;The incidence of adverse reactions during remedial treatment is relatively low;It has advantages in improving gastrointestinal symptoms.