Effects of sequential therapy and quadruple therapy on the eradication of Helicobacter pylori in type 2 diabetes mellitus patients

Objective To investigate the efficacy of sequential therapy and quadruple therapy on Helicobacter py-lori（Hp）eradication in type 2 diabetes mellitus patients. Methods A total of 216 type 2 diabetes mellitus patients with positive Hp infection and planning to take long-term aspirin treatment were enrolled in this study. They were randomly di-vided into sequential therapy group and quadruple therapy group. The patients in sequential therapy group received esome-prazole and amoxicillin for 5 days,and then esomeprazole,clarithromycin and metronidazole for another five days. The pa-tients in quadruple therapy group received esomeprazole,colloidal bismuth subcitrate,amoxicillin and clarithromycin for 10 days. The 14 C-urea breathe test was re-examined at least 4 weeks after the completion of medication,and the negative re-sults indicating the success of Hp eradication. The efficacy,safety and cost-benefit analysis was also evaluated. Hp eradica-tion rates were compared by the intention-to-treat（ITT）and per protocol（PP）analysis. Results According to ITT analy-sis,the eradication rate of Hp in sequential therapy group and quadruple therapy group was 81. 5%（88 / 108）and 84. 3%（91 / 108）. According to PP analysis,the eradication rate of Hp in sequential therapy group and quadruple therapy group was 85. 4%（88 / 103）and 90. 1%（91 / 101）. Both ITT analysis and PP analysis indicated that the Hp eradication rate in sequential therapy group was lower than that in quadruple therapy group. But there was no significant difference between the two group（P 〉 0. 05）. Conclusions Sequential therapy and quadruple therapy can be considered as the first line choice in the eradication of Helicobacter pylori in type 2 diabetes mellitus patients. Key words: Drug therapy; Combination; Diabetes mellitus; Helicobacter pylori; Helicobacter infections