探讨奥美拉唑、枸橼酸铋、阿莫西林、克拉霉素10 d四联疗法治疗幽门螺杆菌(Hp)的临床疗效和安全性。

选取2014年9月至2015年7月收治的108例Hp阳性患者，随机分成两组各54例：治疗组予以奥美拉唑镁肠溶片40 mg，枸橼酸铋钾220 mg，阿莫西林1 000 mg，克拉霉素500 mg，2次/d，连续应用10 d；对照组予以奥美拉唑20 mg，阿莫西林1 000 mg，甲硝唑400 mg，2次/d，连续应用7 d。疗程结束至少4周后采用13C-尿素呼气试验检测Hp，记录Hp根除率、症状缓解率及药物不良反应，消化性溃疡患者复查胃镜确定溃疡愈合情况，比较分析两组患者的临床疗效及安全性。

治疗组Hp根除率90.74%(49/54)，对照组Hp根除率75.92%(42/54)，两组比较差异有统计学意义(P<0.05)；治疗组溃疡治疗有效率、症状缓解的有效率、不良反应率分别为91.67%(33/36)、88.89%(48/54)、11.11%(6/54)，对照组分别为85%(34/40)、83.33%(45/54)、14.81%(8/54)，两组比较差异无统计学意义。

奥美拉唑10天四联疗法根除Hp感染的方案比标准三联疗法根除率高，临床效果可靠，安全性较好，可作为Hp初次治疗的首选方案。

To study the effect and reliability of 10d esomeprazole quadruple therapy on patients with Helicobacter Pylori.

108 patients with Helicobacter Pylori were divided into the therapy group and the control group randomly.In the therapy group, the combined use of esomeprazole(40 mg bid), bismuth potassium citrate(220 mg bid), amoxicillin(1 000 mg bid)and clarithromycin(500 mg bid)were administrated for 10 days.In the control group, the combined use of omeprazole(20 bid), amoxicillin(1 000 mg bid)and metronidazole(400 mg bid)were administrated for 7 days.4 weeks after the course of treatment, Helicobacter Pylori was reexamined, the rate of symptomatic relief and adverse drug reaction were recorded, and gastroscope was used to reexamine for patients with gastrohelcoma.Therapeutic effect and reliability were compared between the two groups.

Helicobacter Pylori eradication rate after therapy was 90.74% in the therapy group and 75.92% in the control group(P<0.05). The effective rate of gastrohelcoma, symptomatic relief, and the rate of adverse drug reaction were 91.67%, 88.89%, 11.11% respectively in the therapy group vs. 85%, 83.33%, 14.81% in the control group, and there were no significant difference.

The HP eradication rate of 10 d esomeprazole quadruple therapy were higher than the standard triple therapy.The 10d esomeprazole quadruple therapy were effective and safe.