Clinical efficacy of sequential therapy and triple therapy in the treatment of Helicobacter pylori peptic ulcer

Objective To investigate the clinical efficacy and safety of sequential therapy(composed of pantoprazole, amoxicillin, clarithromycin, tinidazole) and 7 d, 14 d triple therapy in the treatment of Helicobacter pylori(Hp) peptic ulcer. Methods One hundred and forty-four patients confirmed as Helicobacter pylori peptic ulcer by gastroscopy and 14C urea breath test were randomly divided into the sequential therapy group(n=48), 7 d triple therapy group(n=47), 14 d triple therapy group(n=49). Patients in the sequential therapy group received pantoprazole+amoxicillin for 1~5 d, oral pantoprazole+tinidazole+clarithromycin therapy for 6~10 d. Patients in 7 d triple therapy group received pantoprazole+amoxicillin+clarithromycin for 7 d, while those in 14 d triple therapy group were treated by pantoprazole+amoxicillin+clarithromycin for 14 d. The Hp eradication and adverse reactions one month after treatment were compared between the three groups. Results After 1 month of treatment, the Hp eradication rates of the sequential therapy group(93.6%) and 14 d triple therapy group(90.9%) were significantly higher than that in the 7 d triple therapy group(73.9%), P0.05, There was no significant difference in the Hp eradication rate between the sequential therapy group and the 14 d triple therapy group(P0.05). Adverse reactions were found in 6 patients(12.7%) in the sequential therapy group after treatment, 6 patients(13%) in the 7 d triple therapy group, and 9 patients(20.4%) in the 14 d triple therapy group. The incidence of adverse reactions was significantly higher in the 14 d triple therapy group than the other two groups(P0.05). Conclusion In the treatment of Helicobacter pylori peptic ulcer, 10 d sequential therapy is safe, economical, high efficient, with good patient compliance, which is worthy of wide application in basic hospitals.