Abstract：Objective To explore the application effect of bismuth containing quadruple therapy, sequential therapy and concomitant therapy in Helicobacter pylori (Hp) positive patients. Methods A total of 127 patients with peptic ulcer and chronic gastritis treated in Tongzhou District People′s Hospital of Nantong city from March 2019 to March 2021 were selected as the research subjects. All patients were confirmed by gastroscopy and positive for Hp by 14C urea breath test. According to random number table method, they were divided into bismuth quadruple therapy group (n=43),sequential therapy group (n=42) and companion therapy group (n=42). Hp eradication rate, improvement of clinical symptoms and total incidence of adverse reactions were compared among three groups after treatment. Results The results of intentional analysis showed that the Hp eradication rates of the sequential therapy group, the bismuth quadruple group and the companion therapy group were 69.05%, 79.07% and 85.71%, respectively. There was no statistical significance in the Hp eradication rates of the three groups (P>0.05). According to the results of the protocol set, the Hp eradication rates of the sequential therapy group, the bismuth quadruple therapy group and the companion therapy group were 73.68%, 87.5% and 94.87%, respectively, and the difference of Hp eradication rates among three groups were statistically significant (P<0.05). The Hp eradication rate in the companion therapy group was higher than that in the sequential therapy group, and the difference was statistically significant (P<0.017). There was no statistical significance in symptom scores of the three groups before treatment (P>0.05). After treatment, the symptom scores of patients in the three groups were higher than before, the difference was statistically significant (P<0.05), but there was no statistically significant difference between the symptom scores of patients in the three groups (P>0.05). The total incidence of adverse reactions after treatment was 19.05% (8/42) in the sequential treatment group, 16.28% (7/43) in the bismuth quadruple therapy group and 38.1% (16/42) in the companion treatment group, respectively, and there was no significant difference in the total incidence of adverse reactions among the three groups (P>0.05). Conclusion Companion therapy had the best Hp eradication rate, and the three treatments had similar symptom improvement effects with high safety.
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