| Objectives:To investigate the awareness of HP infection among patients in gastroenterology outpatient clinics,and to explore the efficacy and occurrence of adverse effects of high-dose dual therapy and standard bismuth quadruple therapy in the eradication of HP,so as to provide guidance and suggestions for clinicians to popularize HP-related knowledge and to select HP treatment plans more rationally and effectively.Methods:1.Patients attending the gastroenterology outpatient clinic of a hospital from July to August 2022 were selected,and 500 cases were selected for questionnaire survey according to the order of consultation in a ratio of 5:1.The questionnaire included several aspects such as basic patient information,HP transmission route,detection method and treatment method,etc.Descriptive analysis was used to analyze the knowledge related to HP of patients in the gastroenterology outpatient clinic.2.A total of 280 patients who underwent HP eradication treatment in a tertiary care hospital from January to December 2022 were selected and randomly assigned to four treatment regimen groups according to the order of enrollment.Group SBQT1:esomeprazole magnesium enteric coated capsule 40 mg,1 time/day;clarithromycin tablet 500 mg,2 times/day;amoxicillin capsule 1000 mg,2 times/day;colloidal bismuth dry suspension 150 mg,4 times/day.Group SBQT2: pantoprazole sodium enteric coated tablets 40 mg,2 times/day;clarithromycin tablets,amoxicillin capsules and colloidal bismuth dry suspension as the same in group SBQT1.Group HDDT1:esomeprazole magnesium enteric coated capsules 40 mg,2 times/day;amoxicillin capsules 1000 mg,3 times/day.Group HDDT2: pantoprazole sodium enteric coated tablets 40 mg,3 times/day;amoxicillin capsules 1000 mg,3 times/day.Patients’ gender,age,clinical presentation,past medical history,C13 or C14 breath test results and adverse reactions after taking the drugs were collected to compare and analyze the eradication rate and incidence of adverse reactions of the four different treatment regimens.Results:1.Analysis of the survey on HP awareness among patients in gastroenterology outpatient clinicsIn this study,500 questionnaires were collected and 470 were valid,including323 cases(68.7%)of males and 147 cases(31.3%)of females,with an average age of(33.13±11.65),124 cases(26.4%)of those with previous HP infection and 122 cases(26.0%)of those with HP infection in the surrounding people.It was found that 260(55.3%)of the respondents had reached the level of understanding and 111(23.6%)had better understanding.Only 261(55.5%)of the respondents thought that HP was infectious,287(61.1%)of the respondents did not know the transmission route of HP,284(60.4%)of the respondents thought that HP infection should be actively treated,227(48.3%)of the respondents expressed concern about the side effects of drugs,and only 356(75.7%)of the respondents could adhere to the review.It was further analyzed that the degree of knowledge of outpatients was correlated with the history of previous infection and infection of surrounding people(B=3.897,P<0.001;B=2.607,P<0.001).2.Comparison of eradication efficacy between high-dose dual therapy and standard bismuth quadruple therapyA total of 280 subjects were included in this study,and based on the exclusion criteria,12 cases were excluded from this study,3 cases in the HDDT1 group,4 cases in the HDDT2 group,2 cases in the SBQT1 group;and 3 cases in the SBQT2 group.By ITT analysis,the eradication rate was 84.29% in the HDDT1 group,78.57% in the HDDT2 group,87.14% in the SBQT1 group and 81.43% in the SBQT2 group.By PP analysis,the eradication rate was 88.06% in the HDDT1 group,83.34% in the HDDT2 group,89.71% in the SBQT1 group and 85.07% in the SBQT2 group.Further test,there was no statistically significant difference in eradication effect between the groups(P>0.05).The incidence of adverse reactions was 7.5% in the HDDT1 group and 9.1% in the HDDT2 group,and the incidence of adverse reactions was 19.1% in the SBQT1 group and 22.4% in the SBQT2.The incidence of adverse reactions in the HDDT group was significantly lower than that in the SBQT group(P<0.05).Conclusions:1.Patients in gastroenterology outpatient clinics have some knowledge of HP infection,but the level of awareness is still insufficient.2.Previous HP infection and HP infection in the surrounding population are relevant factors influencing the level of HP awareness in gastroenterology outpatients.3.For gastroenterology outpatients,it is essential to improve knowledge of the infectiousness,transmission routes and detection methods of HP,patient compliance and post-treatment prognosis follow-up.4.Both high-dose dual therapy and standard quadruple therapy can achieve acceptable treatment outcomes and there are no significant differences between them,therefore this regimen can be used as one of the first-line treatment options for HP eradication.5.The high-dose dual therapy regimen is safer and has a lower incidence of adverse events compared to standard quadruple therapy.6.The high-dose dual therapy regimen requires a higher intensity of acid suppression. |
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