Efficacy Of Bismuth-containing Quadruple Therapy For Eradication Of Helicobacter Pylori

Objective: To compare the efficacy of different combinations of bismuth-containing quadruple therapies,and to provide a suitable protocol for clinical empirical treatment of Helicobacter pylori eradication in Liaoning.Methods: A retrospective analysis was performed from January 2019 to November 2019 at the Gastroenterology Clinic of Shengjing Hospital Affiliated to China Medical University.A total of 798 eligible patients,including 322 males and 476 females.According to different eradication schemes,they are divided into the following five groups: Group A: Esomeprazole 20 mg,Amoxicillin 1000 mg,Clarithromycin 500 mg,600 mg Bismuth Potassium Citrate Capsules,2 times / d;Group B: Rabe 20 mg of raprazole,1000 mg of amoxicillin,500 mg of clarithromycin,600 mg of bismuth potassium citrate capsules,2 times / day;Group C: 40 mg of pantoprazole sodium,1000 mg of amoxicillin,500 mg of clarithromycin,citron Potassium Bismuth Capsule 600 mg,2 times / d;Group D: Esomeprazole 20 mg,Amoxicillin 1000 mg,Furanazole 100 mg,Bismuth Potassium Citrate Capsule 600 mg,2 times / d;Group E: Esomem 20 mg of razozole,500 mg of clarithromycin,100 mg of furazolidone,600 mg of bismuth potassium citrate capsules twice daily,the course of treatment for all regimens is 14 days,and the patient is reviewed for a 13 C urea breath test at least 4 weeks after withdrawal To determine whether H.pylori eradication was successful.The schemes with the same antibiotic combination and PPI preparation were divided into two groups,and the eradication rate,the incidence of adverse reactions,and the cost-effectiveness ratio of each scheme in the group were compared..Results:(1)The three groups A,B,and C had the same antibiotic combination(amoxicillin + clarithromycin),and the eradication rates of H.pylori were 86.08%,85.98%,and 88.46%,respectively.There was no significant difference.The incidences of adverse reactions were 6.96%,6.73%,5.12%,and there was no significant difference between the groups(P> 0.05).The effect of C composition is relatively low.(2)The three groups A,D,and E have the same PPI preparation(esomeprazole),and the eradication rates of H.pylori are 86.08%,88.42%,and 73.33%.The eradication rates ofthe two groups are significantly higher than those of E.Group,the difference was statistically significant(P <0.05),the eradication rate in group D was higher than that in group A,and the difference was not statistically significant(P> 0.05).The incidences of adverse reactions were 6.96%,7.34%,and 6.67%,with no significant difference between the groups(P> 0.05).The effect ratio of D composition is lower than that of A group.Conclusions:(1)There is no difference in the eradication rate of esomeprazole,rabeprazole and pantoprazole in the eradication of Helicobacter pylori in quadruple bismuth-containing therapy,while pantoprazole is cheaper.(2)Amoxicillin combined with clarithromycin and amoxicillin combined with furazolidone can be used as first-line experience in the eradication of Helicobacter pylori in our region.The rate is below the acceptable level,and careful consideration should be given to whether it should be used as an empirical treatment for the first eradication of H.pylori.