2024 年第 3 期 第 19 卷

含多西环素和左氧氟沙星的四联补救方案治疗幽门螺杆菌初次根除失败患者的临床效果研究

Clinical effect study on patients with failure of primary eradication of Helicobacter pylori with doxycycline and levofloxacin quadruple remediation regimen

作者：王毅王东旭李捷马忠强罗博文李江宇

英文作者：Wang Yi Wang Dongxu Li Jie Ma Zhongqiang Luo Bowen Li Jiangyu

单位：广西壮族自治区玉林市第一人民医院内科，玉林537000

英文单位：Department of Internal Medicine Yulin First People′s Hospital Guangxi Zhuang Autonomous Region Yulin 537000 China

关键词：幽门螺杆菌；初次根除失败；多西环素；左氧氟沙星；四联补救方案

英文关键词：Helicobacterpylori;Primaryeradicationfailure;Doxycycline;Levofloxacin;Quadrupleremediationregimen

• 摘要：

• 目的 探究含多西环素、左氧氟沙星的四联补救方案治疗幽门螺杆菌(Hp)初次根除失败患者的临床效果。方法 选择广西壮族自治区玉林市第一人民医院自2021年1月至2023年2月收治的166例Hp初次根除失败患者进行临床研究，采用随机数字表法分为对照组和观察组，各83例。对照组患者采用含左氧氟沙星的四联补救方案治疗，观察组患者采用含多西环素、左氧氟沙星的四联补救方案治疗，2组均连续治疗14 d。比较2组患者治疗总有效率、Hp根除率、上腹部胀痛、腹痛、嗳气、反酸等临床症状积分、血清炎症因子水平、免疫功能指标、治疗成本效益及不良反应发生率。结果 观察组治疗后总有效率及Hp根除率均高于对照组［98.8%(82/83)比81.9%(68/83)、97.6%(81/83)比80.7%(67/83)］，差异均有统计学意义（P＜0.05）。治疗后，观察组上腹部胀痛、腹痛、嗳气、反酸临床症状积分，血清炎症因子C反应蛋白、肿瘤坏死因子α、白细胞介素6及白细胞介素8水平均低于对照组（P＜0.05）。治疗后，观察组CD+4、CD+4/CD+8比值高于对照组，CD+8水平低于对照组（均P＜0.05）。观察组治疗成本效益优于对照组（P＜0.05）。2组不良反应发生率比较，差异无统计学意义（P=0.915）。结论 含多西环素、左氧氟沙星的四联补救方案治疗Hp初次根除失败患者的临床效果显著，能快速缓解患者躯体不适症状和炎症反应，提高其免疫力及Hp根除率，且药物安全性高，治疗成本效益更优。

• Objective To investigate the clinical effect of doxycycline-levofloxacin containing quadruple remediation regimen in the treatment of patients with primary eradication failure of Helicobacter pylori (Hp). Methods A total of 166 patients with primary Hp eradication failure admitted to Yulin First People′s Hospital, Guangxi Zhuang Autonomous Region from January 2021 to February 2023 were selected for clinical study. Patients were divided into control group and observation group by the random number table method, with 83 cases in each group. The control group was treated with levofloxacin containing quadruple salvage regimen, and the observation group was treated with doxycycline and levofloxacin containing quadruple salvage regimen, and both groups were continuously treated for 14 d. The total response rate of treatment, Hp eradication rate and clinical symptom (upper abdominal distension and pain, abdominal pain, belching, belching, acid reflux, etc.) scores, serum inflammatory factor level, immune function index, cost-benefit and incidence of adverse reactions were compared between the two groups. Results The total effective rate and Hp eradication rate in the observation group were higher than those in the control group［98.8%(82/83) vs 81.9%(68/83), 97.6%(81/83) vs 80.7%(67/83)］(both P＜0.05). After treatment, the clinical symptom (upper abdominal distension and pain, belching, acid reflux) scores, serum inflammatory factor C-reactive protein, tumor necrosis factor-α, interleukin-6 and interleukin-8 in the observation group were lower than those in the control group (all P＜0.05). After treatment, the CD+4 and CD+4/CD+8 ratio in the observation group were higher than those in the control group, and the CD+8 level was lower than that in the control group (all P＜0.05). The cost-benefit of the observation group was better than that of the control group (P＜0.05). The incidence of adverse reactions between the two groups was not statistically significant (P=0.915). Conclusions  The quadruple remediation regimen containing doxycycline and levofloxacin has significant clinical effect in the treatment of patients with primary eradication failure of Hp, which can not only quickly relieve the symptoms of physical discomfort and inflammatory response, but also improve immunity and Hp eradication rate, and the drug has high safety and cost-effective.