A Clinical Study Of Doxycycline-based Quadruple Regimen As A Therapy For Helicobacter Pylori Eradication

Background and Objective : Kyoto global consensus report on Helicobacter pylori gastritis of 2015 pointed out that Helicobacter pylori gastritis is an infectious disease,and it Generally difficult to spontaneous clearance after Hp infection and cause lifelong infection, unless eradication is given. That Hp infected persons almost all chronic active gastritis. H. pylori infected individuals should be offered eradication therapy, unless there are competing considerations. so more Hp infected people need to receive Hp eradication treatment. At present, there is no clinical treatment program can make the Hp eradication rate of 100%. With the wide use of antibiotics, the Hp resistant strains increased, the eradication rate decreased year by year. The objective of this study is explore doxycycline quadruple therapy efficacy and safety of eradicating the Helicobacter pylori and provides an antibiotic choice for clinical treatment.Methods : Statistics April 2014 - April 2015 in binzhou medical university affiliated hospital of medical clinic and included in the standard of 120 patients with Hp infection were randomly divided into two groups. patients in test group were given esomeprazole 20mg, bismuth potassium citrate 600mg, amoxicillin 1.0g and doxycycline 100mg twice daily for 14 days, patients in control group were given esomeprazole 20mg, bismuth potassium citrate 600mg, amoxicillin 1.0g and clarithromycin 500mg twice daily for 14 days. The esomeprazole, bismuth potassium citrate was taken half an hour before meals,antibiotics were taken immediately after meals. 13C-urea breath test was carried out to judge the eradication of H. pylori when patients were reviewed after stopping medication for at least 4 weeks. Positive results indicated failed eradication of H. pylori,while negative results indicated successful eradication of H. pylori. The adverse reactions such as upper abdominal discomfort, nausea, abdominal distension and diarrhea were recorded during the treatment, and the adverse reactions of the two groups were evaluated. The cost effectiveness analysis of the two groups was carried out.Results : After the treatment, according to the intention-to-treat (ITT) and per-protocol(PP) analysis, the rates of Hp eradication in test group were 81.67% (49/60) and 85.96% (49/57 ) , the rates in control group were 88.33% ( 53/60 ) and 91.38%(53/58) .There was no significant difference between the two groups (P > 0.05). The incidence of adverse reactions in the test group and control group were 8.3% and 15%respectively. There was no significant difference between the two groups (P > 0.05).The adverse reactions were mild, and the symptoms disappeared after discontinuation of the drug. The cost of the test group and the control group-effect were 4.58 and 5.58, the doxycycline-based quadruple regimen cost lower, and easier received for patients.Conclusion : The H. pylori eradication rate of doxycycline-based quadruple regimen compared with the standard quadruple including clarithromycin, there was no statistical difference. The treatment cost is low, easy to be accepted by patients. Therefore the doxycycline-based quadruple regimen is safe,effective,economic,available as an option of Hp eradication therapy in clinical application, but its curative effect still needs further research.