Abstract:

Objective Observation on the clinical efficacy of staged comprehensive therapy for patients with refractory Helicobacter pylori infection（RHPI）. Methods A total of 88 patients with refractory Hp infection who had repeated failures of ≥ 3 times with triple therapy were included from 2018 to 2020 according to the consen⁃ sus recommendation. They were randomly divided into treatment group（45 cases）and control group（43 cases）， of which the treatment group adopt staged comprehensive therapy，namely：early stage（Chinese medicine Banxia Xiexin Decoction plus or minus symptomatic treatment）×7 days；standard triple antibacterial treatment（esomepra⁃ zole + amoxicillin + clarithromycin）+Chinese medicine Sanyu ×10 Days；late stage（Chinese medicine Xiangsha Liujunzi Decoction plus or minus treatment）×7 days The control group received standard quadruple antibacterial treatment（esomeprazole + amoxicillin + clarithromycin + colloidal bismuth tartrate）×14 days. Both groups of patients were rechecked for 13C or 14C breath test after stopping the drug for 1 month. The differences in the efficacy of Hp eradication rate，TCM symptom score before and after treatment，and Hp resuscitation rate after 1 year were compared between the two groups，and adverse reactions were recorded. Results In the treatment group and the control group，the eradication rate of Hp was 93.33% and 81.40%，respectively，and the Hp relapse rate after 1 year was 13.33% and 25.58%，respectively.The Hp eradication rate in the treatment group was significantly higher than that in the control group，the Hp relapse rate after 1 year was significantly lower than that in the control group， and the difference was statistically significant（P < 0.05）；the scores of TCM symptoms in the two groups were improved before and after treatment，and the treatment group had a significant rate of 62.22%. The efficiency was 37.21%，and the treatment group was significantly higher than that in the control group（P < 0.05）；no serious adverse events occurred during the treatment period，and the adverse reactions in the treatment group during the radical cure of Hp were significantly less than those in the control group（P < 0.05）. Conclusion Early Banxia Xiexin Decoction and later stage Xiangsha Liujunzi Decoction combined with Chinese medicine Diyu and triple therapy can significantly increase the eradication rate of RHPI，reduce the relapse rate，relieve symptoms obviously， have definite curative effect and have fewer adverse reactions.

Key words:

Helicobacter pylori, refractory, drug resistance, traditional Chinese medicine, phased treatment