Helectobocractor pylori (HP), otu n'ime ọrịa na - efe efe ndị a na - efe efe na mmadụ. Ọ bụ ihe dị egwu maka ọtụtụ ọrịa, dịka ọnya afọ, gastritis na-adịghị ala, na-anụ ahụ na-ejikọ ya, na malt) lymphoma. Nnyocha e mere egosila na ihichapụ HP nwere ike belata ihe ize ndụ cancer cancer, nwekwuo ọgwụgwọ nke ọnya, ma nwee mkpa ijikọta ya na ọgwụ ọjọọ nwere ike ikpochapụ HP. Enwere ọtụtụ nhọrọ ndị dị iche iche ekike dị: Usoro ọgwụgwọ nke mbụ maka ibute ọrịa gụnyere usoro ịkwụ ụgwọ, na-atụ anya gwọọ ọgwụ mgbochi, usoro ọgwụgwọ, na ọgwụgwọ. N'afọ 2007, kọleji America nke eriri afọ jikọtara ọnụ ọgụgụ triplerycin dị ka ọgwụgwọ mbụ maka ngbasa nke ndị na-anụghị Clarithromycin na enweghị nfụkasị perkalin. Agbanyeghị, n'ime iri afọ ndị na-adịbeghị anya, ọnụego ọtụtụ atọ ígwè nke ọkọlọtọ nwere ≤80% n'ọtụtụ mba. Na Canada, nguzogide nke clarithromycin etolitela site na 1% ruo 11% na 2003. N'ime ndị a na-emeso na 2003. Ntugide Clarithromycin nwere ike ịbụ isi ihe kpatara odida. A pụkwara iji 20% na-eme ihe dị ka nke Austrift IV (na-eguzogide ọgwụ na-eme ka ọ bụrụ nke a na-ele anya -Na ọgwụgwọ na mpaghara nwere obere nguzo. Na mgbakwunye na ụzọ dị n'elu, oke doses nke ppiclulin ma ọ bụ ọgwụ nje ọzọ dịka rifamicin, nke Razolidne, nke na-atụ aro ka ọgwụgwọ ọzọ.

Mmelite nke Usoro Tracons

1.1 Quadruple ọgwụgwọ

Dị ka mkpochapu nke usoro ube nke usoro ọgwụgwọ ọkọlọtọ ga-ada, dị ka usọbọ, quadruple ọgwụgwọ nwere oke ihichapụ. Shaikh et al. Ndị ọrịa 175 nwere ọrịa HP, na-eji Nnyocha (PP) na ebumnuche. Nsonaazụ nke ebumnuche a na-ahụ maka nyocha (nke a na-achọpụta nyocha nke usoro ihe osise dị iche iche: PP = 66), 95-76), ITT = 69/79, 95/79, 95% CI: 51-72); Quadrudropgwọ ọrịa nwere ọnụego mkpochapu dị elu: PP = 91% (102/15), 92/15), 92% CI: 77 ~ 90). Ọ bụ ezie na ọnụego nke ihe ịga nke ọma na-ebelata ọgwụgwọ nke HP mgbe ọ bụla dara ada mgbe ọ bụla dara ụda nke Tincture gosipụtara na ọnụego laraị (95%) dị ka ọgwụgwọ nke atọ. Ọmụmụ ihe ọzọ ruru nkwubi okwu a: Mgbe ị ga-enwe ọgwụ tapyloxloxloxacin, mkpochapụ nke ihe na-egbu egbu na 65%, maka ndị ọrịa na A na-ahọrọkwa ọgwụ mgbochi nje cyclic. N'ezie, iji Tincture Quadrupgwọ ọrịa nwere ihe puru iche nke ihe ojoo, dika ihe ojoo, isi ọwụwa, ma ọ bụ n'ihi na a na-ejikarị ya na China, ọ bụ Enwere ike iji ya dị mfe inweta, ma nwee okelata okelata dị ka ọgwụgwọ ọgwụgwọ. Ọ dị mma ịkwalite n'ụlọ ọgwụ.

1.2 SQT

A na-emeso SQT + Amoxicillin maka ụbọchị ise, wee jiri PPI + gwọọ ya na PPI + Clarithromycin + Metyonidazole maka ụbọchị ise. A na-atụ aro ugbu a dị ka usoro ndebiri nke mbụ maka HP. Nnyocha meta na-ejigide ọnwụ (RCTS) na Korea dabere na SQT% (PP) na 86.4%) ~ 2.209), usoro nwere ike ịbụ na mbụ 5D (ma ọ bụ 7d mbụ) iji Amoxicillin iji bibie ọwa ahụ na Wall Cell, na-eme ka mmetụta nke clantrithromycin rụọ ọrụ. A na-ejikarị SQT dị ka ọgwụgwọ maka ọdịda nke Standard Traction Mba Ọzọ. Agbanyeghị, nyocha egosila na ọnụego atọ ndị na-egbu oge (82.8%) karịrị akarị (14d) dị elu karịa nke usoro ọgwụgwọ oge (76.5%). Otu ọmụmụ ihe chọpụtara na enweghị ọdịiche dị iche iche na HP raadicatiaticatia n'etiti SQT na Standard Tracycin dị elu. SQT nwere ogologo oge ọgwụgwọ, nke nwere ike belata nkwado onye ọrịa na adịghị mma maka mpaghara nwere nnukwu nguzogide na Clarithromycin, yabụ, SQT nwere ike ịtụle mgbe conctureditions iji Tincture.

13 Compapy

Usoro ọgwụgwọ a bụ PPI jikọtara ya na amoxicillin, Metronidazole na Claritromycin. Nyochaa meta gosipụtara na ọnụego mbupu dị elu karịa ọgwụgwọ atọ. Nchịkọta ọzọ meta-meta chọpụtara na ọnụego alalata (90%) dị elu karịa nke Tracport Tracport (78%). Onyinye Maastikt na-egosi na enwere ike iji SQT ma ọ bụ ọgwụgwọ condomitiment na enweghị atụmanya, na ọnụego usoro ọgwụgwọ abụọ yiri ya. Agbanyeghị, na mpaghara ebe clarithromycin na-eguzogide ọgwụ Metyodizole, ọ bara uru karịsịa na ọgwụgwọ cromiment. Agbanyeghị, n'ihi na ọgwụgwọ na-esokọ mejupụtara ụdị ọgwụ nje atọ, a ga-ebelata ọgwụ nje, yabụ na-atụ aro ka atụmatụ ọgwụgwọ mbụ ahụ belụsọ ebe ọgwụgwọ ebe Claritromycin na Metridazole na-eguzogide. A na-ejikarị ya na mpaghara nwere oke iguzogide clarithromycin na Metridazole.

1.4 dị elu

Nnyocha e mere na ịba ụba nke dose na / ma ọ bụ ugboro nke nchịkwa PPI na Amoxicillin karịrị 90%. A na-ahụta mmetụta nje nke Amoxicillin na HP dị ka oge na-adabere, yabụ, ọ na-akawanye njọ iji mee ka ugboro ole ị na-emewanye ugboro. Nke abuo, mgbe a na-edobe pịmp n'afọ 3 na 6, a ga-emechagharịgharị ahụ nke ọma. Mgbe pH na afọ karịrị 6, HP agaghị emepụtaghachi ma mara mma na amoxicillin. LET na-eduzi ọnwụnwa ndị ọrịa na-achịkwa na ndị ọrịa 117 nwere ndị ọrịa HP. E nyere ndị dị elu nke ndị dị elu Amoxicillin 1g, Tid na Bleprezle 20mg, na-enye, na-akụ, na ndị otu njikwa 1G, Tid na Blepreple. 10mg, gwa, mgbe izu 2 nke ọgwụgwọ gasịrị, ọnụego HP dị elu dị 89.8% (PP), nke ukwuu), 80.0% (PP), P <0.05. Ọmụmụ si United States gosipụtara na iji Esomeprazole 40 mg, LD + Amoxicillin 750, ụbọchị 3 / 72.2% ụbọchị ọgwụgwọ, PP = 74.2%. Franceschi et al. Usoro ọgwụgwọ atọ na-enyocha: 1 Standard Tracory: Landola 30mg, Delithromycin 500mg, na-ekwu, na-ekwu, ọnụ ahịa 2 Usoro ọgwụgwọ dị elu: Lansoo Carbazole 30mg, Gode, Clarithromycin 500mg, na-akụ, Amoxicillin 1000mg, usoro ọgwụgwọ bụ 7D; 3Sqt: LansPrazile 30mg + Ọnụego mkpochapu nke usoro ọgwụgwọ atọ ahụ bụ: 55%, 75%, na 73%. Ọdịiche dị n'etiti ọgwụgwọ dị elu na ọkọlọtọ atọ dị mkpa, ma e jiri ya tụnyere SQT. Ọ bụghị ọnụ ọgụgụ dị mkpa. N'ezie, ọmụmụ egosila na Omeprazole na Amoxicillin dị elu emeghị nke ọma ọnụego mkpọchi, ikekwe n'ihi Cyp2c19 Chọọchị. Otutu PPIS na-ahụ maka CPZOL19 enzyme, yabụ ike nke cyp2c1c19 Genetabolite nwere ike imetụta metabolism nke PPI. Esomeprazole bụ tumadi metabolized site na Cytochrome P450 3 A4 enzyme, nke nwere ike belata mmetụta nke Cyp2c19 Gene ruo n'ókè ụfọdụ. Na mgbakwunye, na mgbakwunye na PPI, Amoxicillin, Rifampicin, RIFOLIDON, REVOFOXOX, A na-atụ aro ka usoro ọgwụgwọ dị elu dị elu.

Jikọtara nkwadebe microbial

Na-agbakwunye Microsol Ecool Actions (May) na usoro ọgwụgwọ ọkọlọtọ nwere ike belata mmeghachi omume ọjọọ, mana ọ ka na-arụ ụka ma enwere ike ịba ụba. Nyocha nke ndị meta na-ahụta na T. Sphaeroids nke B. Sphaeroids jikọtara ọnụ na-enwe naanị ọnụọgụ abụọ, n = 93, 95% ci: 1.21), belata Mmeghachi omume na-adịghị mma gụnyere ọsịrrrhea. Zhao Bamin et al. gosiputara na njikọta nke puru iche nwere ike ime ka onulata nke oke, obuna mgbe oputara na ọgwụgwọ, a ka nwere oke iwelata. Ọmụmụ ihe nke ndị ọrịa 85 nwere ndị ọrịa HP na-enweghị nsogbu na 4 nke Lactobacillus 20 MG BLACKỌ 500 MG RECE, na Tinidazole 500 mg. . Ọdịiche dị na ọnụ ọgụgụ dị n'etiti otu ndị dị n'etiti otu ahụ, mana otu nsogbu niile bara uru na-egbochi mmeghachi omume ọjọọ karịa otu ndị otu na-ahụ maka mmeghachi omume na-akpata mmekọrịta dị n'etiti. Ihe eji eme ihe nke ihe aghaghi nke oma, ma nwee ike igbochi ma obu inabata ya na ebe di iche iche dika ihe di iche iche dika ihe ndi ahu di iche na nje. Agbanyeghị, ụfọdụ ọmụmụ achọpụtala na njikọta nke ndị mmekọ na-adịghị mma ka ọnụ ọgụgụ ndị na-adịghị mma, nke nwere ike ibute mmetụta ndị ọzọ na-enwe naanị mgbe ọgwụ nje na-adịghị ike. A ka nwere nnukwu ohere na njikọta njikọta, yana nyocha ndị ọzọ na ụdị, ọgwụgwọ ọgwụgwọ, ihe ngosi na oge nchịkọta nchịkwa.

Ihe na-emetụta ọnụego HP

Ọtụtụ ihe na-emetụta HP a na-emetụta mgbochi nje, mpaghara, ị smokingụ ọgbụgba, gastric oge, nzaghachi nke PPI, na CPEN2c19 Gene polymorphism. Ọnụnọ. Nnyocha e mere na nyocha nke nyocha, afọ, ọgwụ, ọgwụ, na-egbochi ọrịa, PPI, na ọnụego ọgwụgwọ. Na mgbakwunye, ụfọdụ nwere ike ọrịa, dịka ọrịa shuga, ọbara mgbali, ọrịa ọrịa na-adịghị ala ala, ọrịa na-adịghị ala ala nwekwara ike ijikọ ya na mkpochapụ nke HP. Agbanyeghị, nsonaazụ nke ọmụmụ ugbu a abụghị otu, a chọrọ ọmụmụ ihe buru ibu karịa.