Eradication Efficacy of Three Therapeutic Regimens for Helicobacter Pylori

OBJECTIVE:To evaluate the eradication efficacy of triple therapy,quadruple therapy and sequential therapy for helicobacter pylori(Hp).METHODS:240 patients with Hp infection who had diagnosed by gastroscopy as having chronic gastritis and peptic ulcer were randomly assigned to the triple therapy group(rabeprazole+amoxicillin+clarithromycin),quadruple therapy group(rabeprazole+amoxicillin+clarithromycin+colloidal bismuth pectin) or sequential therapy group(rabepazole+amoxicillin for the first 5 days,followed by rabepazole+clarithromycin+metronidazole for second 5 days).After drug withdrawal of 4 weeks,14C-urea breath test was performed to compare the Hp eradication rate among the 3 groups.RESULTS:(1)Intention-to-treat(ITT) analysis revealed eradication rates of 73.75%,92.5% and 81.25%,respectively in triple therapy group,quadruple therapy group and sequential therapy;per-protocol(PP) analysis revealed Hp eradication rates of 77.63%,93.67% and 83.33%,respectively;compared by the ITT analysis and PP analysis,quadruple therapy was better than both triple therapy and sequential therapy in terms of Hp eradication rate and the differences were significant(P0.05),yet no significant difference was noted between triple therapy and sequential therapy.(2)ITT analysis revealed cost-effectiveness ratios of1.75,1.57 and 1.79,respectively in triple therapy,quadruple therapy and sequential therapy groups;PP analysis revealed cost-effectiveness ratios of 1.67,1.55 and 1.65,respectively.CONCLUSION:The quadruple therapy was proved to be an effective,safe and economical regimen for Hp eradication.