Clinical Study On Individualized Treatment Of Helicobacter Pylori Infection In Adults In Jinhu Area

Objective 1.To investigate the resistance of Helicobacter pylori,isolated from the gastric mucosa of recently treated patients with Helicobacter pylori infection in Jinhu area,to the common clinical antibiotics(clarithromycin,amoxicillin,furazolidone,metronidazole,levofloxacin,tetracycline).2.To compare the eradication rate of Helicobacter pylori between the experimental treatment group and the individualized treatment group.3.To investigate the effectiveness of Helicobacter pylori eradication of Helicobacter pylori on the improvement of digestive tract symptoms in patients.Method 1.From July 2016 to December 2017,64 patients with positive 3C urea breath test were collected from Jinhu people Hospital from July 2016 to December 2017.2.The gastric mucosal tissue was fully ground and cultured in a 370C three-air incubator with Colombian blood Agar for 96 hours.The suspected colonies were observed by naked eye,examined via Gram staining,and tested with urease.Catalase and perhydride enzyme were identified.3.The resistance of Helicobacter pylori to amoxicillin,clarithromycin,levofloxacin,furazolidone,metronidazole and tetracycline was detected.4.64 patients were randomized,parallel,while the control group was single-blind.The patients in the experimental group were divided into the experiential treatment group and the individualized treatment group.The 32 patients in the experiential treatment group were given esomeprazole 20 mg bid,amoxicillin 1000 mg bid,clarithromycin 500 mg bid,colloidal pectin bismuth 200 mg bid for 14 days.Clarithromycin resistant group:for example,levofloxacin sensitive group:esomeprazole 20 mg bid,amoxicillin 1000 mg bid,clarithromycin 500 mg bid,amoxicillin 1000 mg bid,levofloxacin 500 mg qd,a total of 14 days.Amoxicillin 1000mg bid,furazolidone 100mg bid for 14 days.The eradication rate of Helicobacter pylori between two groups was compared.Result 1.There were 64 cases of positive 13C breath test in Jinhu area,including 38 males(59.38%)and 26 females(40.62%).The average age was 49.56±8.44 years,48.37±9.56 years for males and 51.31±6.06 years for females.2.Helicobacter pylori was isolated from 59 patients with 13C urea breath test positive in Jinhu area.The positive rate of culture was 92.19%.The drug resistance rates to metronidazole,levofloxacin and clarithromycin were 91.53%and 66.10%respectively.The ratio of resistance to three antibiotics was 38.98%.3.The eradication rate of experiential treatment group was 96.88%and that of individualized treatment group was 93.55%.There was no statistical significant difference between the two groups.Conclusion 1.There are many multidrug resistant bacteria in this area.2.Standard tetralogy(esomeprazole 20mg bid amoxicillin 1000mg bid clarithromycin 500mg bid colloidal bismuth 200mg bid,for 14 days)had a high eradication rate for patients who were first eradicated of H.pylori.There was no significant difference in eradication rate between the experiential treatment group and the individualized treatment group.3.After the eradication of H.pylori treatment,the symptoms of dyspepsia were improved in different degrees.