Clinical effect study on patients with failure of primary eradication of Helicobacter pylori with doxycycline and levofloxacin quadruple remediation regimen

Wang Yi; Wang Dongxu; Li Jie; Ma Zhongqiang; Luo Bowen; Li Jiangyu

doi:10.3760/j.issn.1673-4777.2024.03.016

Abstract：Objective To investigate the clinical effect of doxycycline-levofloxacin containing quadruple remediation regimen in the treatment of patients with primary eradication failure of Helicobacter pylori(Hp).Methods A total of 166 patients with primary Hp eradication failure admitted to Yulin First People's Hospital,Guangxi Zhuang Autonomous Region from January 2021 to February 2023 were selected for clinical study.Patients were divided into control group and observation group by the random number table method,with 83 cases in each group.The control group was treated with levofloxacin containing quadruple salvage regimen,and the observation group was treated with doxycycline and levofloxacin containing quadruple salvage regimen,and both groups were continuously treated for 14 d.The total response rate of treatment,Hp eradication rate and clinical symptom(upper abdominal distension and pain,abdominal pain,belching,belching,acid reflux,etc.)scores,serum inflammatory factor level,immune function index,cost-benefit and incidence of adverse reactions were compared between the two groups.Results The total effective rate and Hp eradication rate in the observation group were higher than those in the control group[98.8％(82/83)vs 81.9％(68/83),97.6％(81/83)vs 80.7％(67/83)](both P＜0.05).After treatment,the clinical symptom(upper abdominal distension and pain,belching,acid reflux)scores,serum inflammatory factor C-reactive protein,tumor necrosis factor-α,interleukin-6 and interleukin-8 in the observation group were lower than those in the control group(all P＜0.05).After treatment,the CD4+ and CD4+/CD8+ ratio in the observation group were higher than those in the control group,and the CD8+level was lower than that in the control group(all P＜0.05).The cost-benefit of the observation group was better than that of the control group(P＜0.05).The incidence of adverse reactions between the two groups was not statistically significant(P=0.915).Conclusions The quadruple remediation regimen containing doxycycline and levofloxacin has significant clinical effect in the treatment of patients with primary eradication failure of Hp,which can not only quickly relieve the symptoms of physical discomfort and inflammatory response,but also improve immunity and Hp eradication rate,and the drug has high safety and cost-effective.