Analysis Of Different Drug Regiments Influencing The Eradication Of Helicobacter Pylori In Xi'an

Objectives: 1 To analyze the efficacy of therapy based on different combinations of drugs on eradication of Helicobacter pylori(Hp).2 To analyze the efficacy of gender,age group and diagnosis of upper gastrointestinal on eradication of Helicobacter pylori.Methods: 1.Subjects: A total of 316 outpatients not used acid suppressive drugs,antibiotics and bismuth within 28 days who were referred to Shaanxi Provincial People's Hospital from June 1st,2014 to June 1st,2016 were selected.227 cases of them completed treatment(Research Group).89 cases of them were lost to follow-up(loss to follow-up group)of who failed to take medical advice and recheck 13C-urea breath test over 28 days after completion of treatment.All their gender,age,diagnosis by gastroscopy,treatment on eradication of Hp,course of treatment and therapeutic effect were analysed by the way of observation record.2 Methods: Research Group were randomly allocated to RAN+AMO+CLA 14 d group(Ranitidine + amoxicillin + clarithromycin 14 days of therapy)?PAN+AMO+CLA 14 d group(Pantoprazole+ amoxicillin+ clarithromycin therapy for 14 days)?PAN+AMO+CLA+BIS 14 d group(Pantoprazole+ amoxicillin+ clarithromycin + colloidal bismuth tartrate 14 days of therapy)?PAN+AMO+CLA+BIS 10 d group(Pantoprazole+ amoxicillin+ clarithromycin+ colloidal bismuth tartrate 10 days of therapy)?OME+AMO+MET+BIS 14 d group(Omeprazole+ amoxicillin+ metronidazole + colloidal bismuth tartrate 14 days treatment)?PAN+AMO+LEV+BIS 10 d group(Pantoprazole+ amoxicillin+ levofloxacin+ colloidal bismuth tartrate 10 days of therapy).Compared different therapies on the eradication of Hp in Research Group.Compared different gender,age group and diagnosis of upper gastrointestinal on eradication of Hp in PAN+AMO+CLA+BIS10d or 14 d group.Multivariate Logistic regression was used to analyze the effects of different therapy,gender,age,and diagnosis of upper gastrointestinal on eradication of Helicobacter pylori.3 Statistical analysis: All the calculation were performed in SPSS 19.0.Chi-Square Test and Fisher's exact probability was used in univariate analyses whereas logistic regression was used in multivariate analyses.Probability value less than 0.05 was considered statistically significant.Results: 1 The proportion aged 30~40 years old of the loss to follow-up group was 30.3% with the highest.2 Comparision of efficacy of Different therapy on eradication of Helicobacter pylori among Research Group 2.1 Eradication rate of PAN+AMO+CLA+BIS14d group were significantly higher than PAN+AMO+CLA14d group and RAN+AMO+CLA 14 d group.2.2 Eradication rate of OME+AMO+MET+BIS14d group were significantly higher than RAN+AMO+CLA 14 d group.2.3 Among proton pump inhibitor+ amoxicillin+ another antibiotic+ colloidal bismuth tartrate therapy,the eradication rate of Hp was highest in OME+AMO+MET+BIS14d group(94.12%),lowest in PAN+AMO+LEV+BIS10d group(64.71%),but there was no statistically significant differences among them.2.4 There were no statistically significant differences between PAN+AMO+CLA+BIS14d group and PAN+AMO+CLA+BIS10d group.3 The Eradication rate was no statistically significant differences between Male and Female among PAN+AMO+LEV+BIS10d and 14 d group.The Hp eradication rates was lowest among patient under 40 years old and highest among age over 60 years old.But There were no statistically significant differences between them(75.7%vs93.3%,P>0.05).The Eradication rate of Hp was no statistically significant differences among chronic atrophic gastritis,chronic non-atrophic gastritis and Peptic ulcer.4 Logistic stepwise regression analysis showed that gender,age and diagnosis of upper gastrointestinal were not the factors influencing the efficacy of eradication rate of Hp.Terapy was the factor influencing the efficacy of eradication rate of Hp.Conclusions: 1 Therapy program was factor influencing eradication of Helicobacter pylori infection,but gender,age and diagnosis by gastroscopy have little effect on Hp eradication rates.2 The efficacy of Ranitidine + amoxicillin + clarithromycin 14 days of therapy and Pantoprazole + amoxicillin + clarithromycin therapy for 14 days was poor on eradication of Helicobacter pylori.The combination of bismuth is beneficial to improve Hp eradication rates.The combined effect of proton pump inhibitors,bismuth,amoxicillin and metronidazole for14 days may be great.The reason may be that the resistance of metronidazole can be completely or partly offset with the increase of times and dosage of metronidazole.The Hp eradication rates was low with a bismuth quadruple regimen containing levofloxacin.The reason may be levofloxacin resisitance in this region.3 The Hp eradication rates was lowest among patient under 40 years old.The proportion of the loss to follow-up was higest under 40 years old,too.The next thing to be done is to focuse on and inprove the eradication rate of Hp among patients under 40 years old.