Abstract:

Objective To compare the eradication rate and adverse incidence of proton pump inhibitor high dose dual therapy with bismuth-containing quadruple therapy for Helicobacter pylori (H.pylori). Methods From January 2021 to August 2021, a total of 208 patients with positive H.pylori admitted to the Department of Gastroenterology, Hebei General Hospital were enrolled and randomly grouped into experimental group (n=105, proton pump inhibitor high dose dual therapy) and control group (n=103, bismuth-containing quadruple therapy). The patients in experimental group were given oral administration of esomeprazole 40 mg two times a day and amoxicillin 750 mg a day, and patients in control group were given esomeprazole 20 mg two times a day, colloidal bismuth subcitrate 220 mg two times a day, amoxicillin 1 000 mg two times a day, Furazolidone 100 mg two times a day. The treatment period for both groups was 14 days; after 4 week, ¹³C/¹⁴C urease breath test (¹³C/¹⁴C-UBT) for detecting H.pylori infection was performed and the eradication rate and adverse incidence were compared.Results The eradication rate of H.pylori for the experimental group and the control group were 77.1% and 82.5% (P=0.334) in intention-to-treat (ITT) analysis; the eradication rate of H.pylori for the experimental group and the control group were 82.7% and 87.6%(P=0.329) in per-protocol (PP) analysis. The incidence of adverse reactions in the experimental group was 9.0%, which was significantly lower than 19.0% in the control group (P=0.042). Adverse reactions in the experimental group were mainly bloating, diarrhea and rash; adverse reactions were mainly oral odor, constipation and abdominal pain in the control group. Conclusion The eradication rate was similar both proton pump inhibitor high dose dual therapy and bismuth-containing quadruple therapy; but proton pump inhibitor high dose dual therapy has significantly lower incidence for adverse reactions, expecting to be optimal eradication program.

Key words: Helicobacter pylori, proton pump inhibitors, bismuth-containing quadruple therapy, eradication rate, adverse reactions