Evaluation of Clinical Efficacy of Vonoprazan in the Radical Treatment of Helicobacter Pylori
Objective To optimize the medication regimen for radical treatment of Helicobacter pylori(HP).Methods A total of 312 patients diagnosed with HP in hospital physical examination center or outpatient and without ulcer or other gastric mucosal lesion confirmed by gastroscopy from January 2020 to December 2022 were selected.They were divided into the proton pump inhibitor(PPI)-based quadruple therapy group(124 cases),vonoprazan(VPZ)-based quadruple therapy group(84 cases)and VPZ-based dual therapy group(97 cases)based on different eradication regimens.The patients in the PPI-based quadruple therapy group were given Esomeprazole Enteric Capsules[20 mg each time,twice a day(bid)]+Amoxicillin Capsules(1 g each time,bid)+Clarithromycin Sustained Release Capsules(500 mg each time,bid)+Colloidal Bismuth Pectin Capsules[200 mg each time,three times a day(tid)].The patients in the VPZ-based quadruple therapy group were given Vonoprazan Fumarate Tablets(20 mg each time,bid)+Amoxicillin Capsules(1 g each time,bid)+Clarithromycin Sustained Release Capsules(500 mg each time,bid)+Colloidal Bismuth Pectin Capsules(200 mg each time,tid).The patients in the VPZ-based dual therapy group were given Vonoprazan Fumarate Tablets(20 mg each time,bid)+Amoxicillin Capsules(1 g each time,tid).All three groups were treated orally with a course of 14 d.Results The success rates of HP eradication in the PPI-based quadruple therapy group,VPZ-based quadruple therapy group and VPZ-based dual therapy group were 85.48%,90.48%,88.66%respectively,with no significant difference among the groups(P>0.05),and only the VPZ-based quadruple therapy group had a satisfactory eradication effect(eradication rate>90%).The incidence rates of adverse events in the above three groups were 15.32%,16.67%,7.72%respectively,with significant differences among the groups(P<0.05).Conclusion In the radical treatment of HP in the population without ulcer or gastric mucosal lesion,the success rate of HP eradication and incidence of adverse events of VPZ-based quadruple therapy are slightly higher than those of traditional PPI-based quadruple therapy.Although the success rate of HP eradication of VPZ-based dual therapy(containing high-dose amoxicillin)is slightly higher than that of PPI-based quadruple therapy,it is still unsatisfactory.More clinical researches are needed in the future to achieve more ideal eradication effects.
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