Helicobacter Pylori (HP), ɗayan cututtukan cututtuka masu kamuwa da cuta a cikin mutane. Fa'idar haɗari ga cututtuka da yawa, kamar cututtukan ciki, na na mahaifa adencarcinoma na ciki, har ma da mucosa-mai alaƙa da ƙwayar cuta (malt) lymphoma. Karatun ya nuna cewa kawar da cutar HP na iya rage haɗarin ciwon kansa, kuma a halin yanzu yana buƙatar haɗuwa tare da magunguna na iya kawar da HP. Akwai zaɓuɓɓukan erarem na farko na cirewa a asibiti waɗanda suke akwai: magani na farko don kamuwa da cuta ta hanyar kamuwa da cuta, magudanar lu'ulu'u, magani mai gudana. A shekara ta 2007, Kwalejin Gastroenterologologology hade farji sau uku tare da clithroromyjin a matsayin maganin farko na mutane da ba su sami clithin mutanen da ba su sami rashin lafiyan mutane ba. Koyaya, a cikin 'yan shekarun nan, eradication na daidaitaccen daidaitaccen daidaitaccen tsarin uku ya kasance ≤80% a yawancin ƙasashe. A Kanada, Kimar Jigilar Prithithorromomyjin ya karu daga 1% a cikin 1990 zuwa kashi na 200% a 2003. Kasar da aka bi da su, an horar da su kusan kashi 60%. CLICHROMOMOMINCIN YANA CIKIN CIKIN SAUKI NA GOMA SHAWARA. MaastrichT IV Rahoton Rahoton A cikin yankunan da ke da tsaurara kan 15% zuwa 20%) -line jeri a cikin wuraren da ƙarancin juriya ga Mycin. Baya ga hanyoyin da ke sama, babban allurai na ppi da amoxicillin ko madadin ribasicalin, Furaizolidone an ba shi shawarar azaman madadin jiyya na farko.

Inganta daidaitaccen Triple

1.1 Qadruple Farashin

Kamar yadda eradication na daidaitaccen tsari sau uku arya ya fadi, a matsayin magani, maganin quadruple yana da babban karama. Shaikh et al. Bi da Marasa lafiya 175 tare da kamuwa da cutar HP, ta amfani da tsarin tantancewa (PP) da niyya. Sakamakon aikin don kula da (ITT) kimantawa na kawar da eradication na daidaitaccen Triple: PP = 65% (45/74), 95% (49/79) CI: 51-72); Kudin Quadruple yana da mafi girma eradication na eradication: PP = 91% (102/112, 95% ci: 84%: (102/121, 95% ci: 75% Kodayake nasarar da aka samu nasarar kawar da HP ya ragu bayan kowace bata da magani, maganganun quadruple) a matsayin magani bayan gazawar Triple Farawa. Wani nazarin ya kai irin wannan maganar: bayan gazawar daidaitaccen Triple Fariyata da Levofloxacin Triumpy, da 65%, bi da bijirewa Qurucin Asipy An fi so maganin maganin cyclic lactone, an fi so maganin fata. Tabbas, yin amfani da tincture quadure quadratulle aryrupple yana da babban yiwuwa na abubuwan da ke faruwa, kamar dan usesi, mena, dandano, ciwon kai, mitan dandano, da sauransu. in mun gwada da sauki don samu, kuma yana da mafi girman darajar eradication azaman magani mai magani. Yana da mahimmanci inganta a cikin asibitin.

1.2 SQT

An bi da Sqt tare da PPI + AMOXICICILIN na kwanaki 5, sannan a bi da shi tare da PPI + protithroromycin + metronidazole tsawon kwanaki 5. A halin yanzu an ba da shawarar a halin yanzu azaman maganin farko na farko don hp. Wani bincike mai tsari na gwaji shida da aka tsara (RCTs) a cikin Koriya ya dogara da SQT shine 79.4% (PP), da HQ Eradication na SQT. 95% CI: 1.403 ~ 2.209), inji yana iya zama cewa farkon 5D (ko 7D) yi amfani da amoxicllin don lalata tsarin riga-zane a jikin tantanin halitta, yin tasirin tsari na tantanin halitta, yana yin tasirin tsari na tantanin halitta. Ana amfani da sqt sau da yawa azaman magani don rashin nasarar daidaitaccen Triple Trapy arrop a ƙasashen waje. Koyaya, karatu ya nuna cewa samar da sau uku na triple (82.8%) akan lokaci mai tsawo (14D) ya fi na yawan farjin na gargajiya (76.5%). Nazarin daya na karatu da cewa babu wani gagarumin banbanci a cikin eradication na HP tsakanin SQT da daidaitaccen magunguna, wanda zai iya dangantaka da mafi girman adadin clithromomycin jure. SQT yana da tsawon lokaci na magani, wanda na iya rage yawan yarda kuma bai dace da wuraren da ke da tsayayya wa presithomin ba, don haka sqt ana iya ɗauka lokacin da aka kama shi lokacin da aka kama don tincture.

1.3 Abokan Arashipy

Ana rakiyar magani shine ppi tare da amoxicillin, metronidazole da clhitromycin. Binciken meta-bincike ya nuna cewa kawar da eradication ya fi daidai da daidaitaccen tsarin uku. Wani bincike na bincike ya gano cewa kawar da eradication (90%) ya fi girma sosai fiye da na daidaitaccen Triple Farawar (78%). Maastricht IV Ba'ams ya nuna cewa sqtorant farta za a iya amfani da sqcomatant a cikin rashin tsammanin, da kuma kawar da iradiyya na kwayar halittu biyu. Koyaya, a cikin wuraren da prolitherycin ne resistant zuwa Metronidazole, ya fi more rayuwa tare da kwantar da hankali. Koyaya, saboda farawar rakiyar ta ƙunshi nau'ikan rigakafin rigakafi guda uku, za a rage zaɓin rigakafin ƙwayoyin cuta, don haka ba a ba da shawarar a matsayin wuraren da na magani na farko ba sai don yankan da aka yiwa na farko. Yawancin lokaci ana amfani da su a cikin wuraren da ƙarancin juriya ga Currithacin da Metronidazole.

1.4 mafi girma magani

Nazarin sun gano cewa karuwa da kashi da / ko mita na gwamnatin ppi da amoxicicillin ya fi 90%. Tasirin kwayoyin cuta na Amoxicillin akan HP ana ɗauka lokaci-lokaci ne, sabili da haka, ya fi dacewa don ƙara yawan adadin gudanarwa. Abu na biyu, lokacin da ph a ciki yana ci gaba tsakanin 3 da 6, ana iya hana zantse da kyau. Lokacin da ph a cikin ciki ya wuce 6, HP ba zai sake yin rubutu ba kuma yana kula da Amoxillin. Ren AL, an gudanar da gwajin da aka sarrafa shi a cikin marasa lafiya na 117 tare da marasa lafiya na HP. An ba da babbar rukunin Amoxicillin 1G, tid da RABEPRAZO 20MG, TID, an ba da rukunin sarrafawa AMOXICILLILLIN 1G, tid da Rabbizole. Yaki 10mg, bayan makonni 2 na jiyya, matakin farko na kungiyar HP ya kai kashi 89.9% (ITT), 83.9% (ITT), 80.0% (PP), P <0.05. Nazarin daga Amurka ya nuna cewa ta amfani da Eesprazole 40 MG, LD + Amoxicillin 750 MG, kwanaki 3, ITT 34.2% bayan 74.2%. Franceschi et al. Sake bincika jiyya uku: 1 daidaitaccen Farfesa: Lansoola 30mg, Bid, 7000MG, BID, 7D; 2 Babban-kashi Carbihole 30mg, tayin, protholycin 500mg, tid, idoxillin 1000mg, tid, za a tid, za a tid, za a yiwa darasi na magani 7d; 3SQT: Lansoprazole 30mg, BID + Amoxicillin 1000mg, yi wa BID na 5DAZOLID BID da kwanaki 5. A cradication Restern of ukun recomens reshirens sun kasance: 55%, 75%, da 73%. Bambanci tsakanin m-kashi da daidaitaccen tsari na yau da kullun yana da mahimmanci ƙididdiga, kuma bambanci an kwatanta shi da SQT. Ba ilimin lissafi ba. Tabbas, karatun ya nuna cewa omeprazuzole da amoxrazularin farawar ƙwayar cuta bai inganta matakan kawar da kai ba, wataƙila saboda gentoype na Cyp2c19. Yawancin ppis suna narkar da enzyme ta hanyar cyp2c19, don haka ƙarfin metabolite na cyp2c19 na iya shafar metabolism na PPI. Esomeprazole galibi ana narkar da cynochrozed ta Cynyprome P450 3 enzyme na A4, wanda zai iya rage tasirin cyp2c19 Gene zuwa wani har zuwa wani lokaci. Bugu da kari, ban da PPI, AMFAMamicicin, Furamolidone, Furaizoladin, Levofloxacin, ana kuma ba da shawarar azaman madadin magani mai kyau.

Hada shiri na microbial

Dingara ga wakilan masu zaman kansu (Mea) don daidaitawa na iya rage mummunan halayen, amma har yanzu mai rikitarwa ne ko na eradication na eradication zai iya ƙaruwa. Bincike na meta-bincike ya gano cewa yakin B. SPHAEREREDIDED tare da Farashi Uraication kadai, 915, RR = 1.05) ~ ~ 1.21), kuma rage m hali gami da gudawa. Zhao Badin et al. Hakanan ya nuna cewa hadewar probotics na iya inganta ƙididdigar kawar da eradication, ko da bayan rage hanya na lura, har yanzu akwai babban darajar eradication. Nazarin marasa lafiya 85 tare da marasa lafiya masu kyau na HP zuwa cikin rukuni 4 na Lactitachacillysin 500 MG Bid, da Tindizole 500 MG karo. , B. Cenewaiae, Lacobacacillillus hade tare da Bifidobacteria, Placebo na mako mai zuwa makonni 4, daga baya sati 5 da ta'aziyya da ta'aziyya babu wani muhimmi Bambanci a cikin kawar da eradication tsakanin ƙungiyoyin, amma duk ƙungiyoyin ƙwarewa sun fi fama da rashin nasara fiye da ƙungiyar sarrafawa, kuma babu wani mahimmin mahimman halayen miyagu tsakanin ƙungiyoyin masu kawo ƙarfi. Hanyar da probiquics ta kawar da HP har yanzu ba a san shi ba, kuma yana iya hana shi ko tsaftacewa tare da shafuka masu gasa da kuma abubuwa daban-daban. Koyaya, wasu nazarin sun gano cewa haɗuwa da probiots baya inganta ragi na kawar da magabaci ne kawai lokacin da maganin rigakafi ba su da inganci. Har yanzu akwai babbar hanyar bincike a cikin haɗin gwiwa a cikin haɗin gwiwa, da ƙarin bincike ana buƙatar bincike akan nau'ikan, darussan magani, alamomi da lokacin shirye-shiryen shirye-shirye.

Abubuwan da suka shafi Kudin HP Eradication

Abubuwa da yawa da suka shafi eradication na HP sun haɗa da juriya na kwayar cuta, yankin haƙuri, rashin lafiya na yau da kullun, martani na ciki ga pplymorphentism. Gaban. Nazarin ya ba da rahoton cewa a cikin binciken da ba a sani ba, shekaru, yankin mai zama, magani, cututtukan ruwa, comenctionity, eradenction yana da alaƙa da kudadenku. Bugu da kari, wasu munanan cututtuka na kullum, kamar su ciwon sukari, cututtukan fata, na kullum cutar hanta, da cutar huhu na kullum na iya kasancewa da alaƙa da nauyin kawar da HP. Koyaya, sakamakon binciken na yanzu ba ɗaya bane, kuma ƙarin bincike mai sikelin yana buƙatar.