Abstract:

Objective　To explore the efficacy and safety of the treatment for Helicobacter pylori (H.pylori) infection in penicillin-sensitive people with quadruple regimens containing furazolidone or metronidazole. Methods　The clinical data of 120 patients with H.pylori infection who were treated with quadruple regimens containing furazolidone or metronidazole from June 2021 to April 2023 in Dongguan Songshan Lake Tungwah Hospital due to allergy to penicillin were collected. The patients were divided into a furazolidone group (62 cases) and a metronidazole group (58 cases) according to the drugs they took. All the patients received ¹³C urea breath test again at least 4 weeks after the treatment. The general information and incidences of adverse reactions of the two groups were compared. Intention to treat (ITT) and per protocol (PP) were used to analyze the eradication rates of H.pylori in the two groups. t and χ² tests were applied. Results　Among the 120 patients, 97 completed the treatment and follow-up; there were 50 cases in the furazolidone group, including 25 males and 25 females, with an age of (38.7±11.2) years; there were 47 cases in the metronidazole group, including 21 males and 26 females, with an age of (41.9±11.6) years. The overall incidence of adverse reactions in the furazolidone group was 28.0% (14/50), and that in the metronidazole group was 17.0% (8/47), with no statistical difference (χ²=1.655, P>0.05). The ITT and PP analyses showed that the eradication rates of H.pylori in the furazolidone group were 72.6% (45/62) and 90.0% (45/50), and those in the metronidazole group were 74.1% (43/58) and 91.5% (43/47), with no statistical differences (χ²=0.037 and 0.064; both P>0.05). Conclusions　The quadruple regimens containing furazolidone or metronidazole are effective in the eradication of H.pylori infection, but there are certain adverse reactions. They can be used as plans and choices for the initial treatment of H. pylori infection in people with penicillin allergy.

Key words:

Helicobacter pylori, Furazolidone, Metronidazole

摘要：

目的　探讨含呋喃唑酮与含甲硝唑的四联方案治疗青霉素过敏人群幽门螺杆菌（Helicobacter pylori，H.pylori）感染的疗效及安全性。方法　收集东莞松山湖东华医院自2021年6月至2023年4月因对青霉素过敏而采用含呋喃唑酮或含甲硝唑的四联方案治疗H.pylori感染的120例患者的临床资料。根据患者的药物使用情况分为呋喃唑酮组（62例）和甲硝唑组（58例）。所有患者在治疗结束后至少4周再次接受¹³C尿素呼气试验检查。比较两组患者一般资料和不良反应发生率。采用意向性治疗（intention to treat，ITT）和符合方案集（per protocol，PP）分析两组患者的H.pylori根除率。采用t检验和χ²检验。结果　120例患者中共有97例患者完成治疗、随访和复查；呋喃唑酮组50例，男25例，女25例，年龄（38.7±11.2）岁；甲硝唑组47例，男21例，女26例，年龄（41.9±11.6）岁。呋喃唑酮组不良反应总发生率为28.0%（14/50），甲硝唑组为17.0%（8/47），差异无统计学意义（χ²=1.655，P>0.05）。呋喃唑酮组ITT和PP分析H.pylori根除率分别为72.6%（45/62）、90.0%（45/50），甲硝唑组分别为74.1%（43/58）、91.5%（43/47），差异均无统计学意义（χ²=0.037、0.064，均P>0.05）。结论　含呋喃唑酮与含甲硝唑四联方案根除H.pylori感染效果确切，但存在一定的不良反应，可作为青霉素过敏人群初始治疗H.pylori感染的方案和选择。

关键词:

幽门螺杆菌, 呋喃唑酮, 甲硝唑