Therapeutic effect of triple therapy combined with posture change after taking medicine for helicobacter pylori eradication in remnant stomach
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The effect of conventional therapy for Helicobacter pylori (Hp) eradication in remnant stomach is controversial. To evaluate the efficacy and safety of triple therapy combined with posture change after taking medicine for Hp eradication in remnant stomach. A total of 54 Hp infected patients with remnant stomach and 30 Hp infected patients with intact stomach were enrolled. Patients with remnant stomach were randomly assigned into remnant stomach A and B groups, and patients with intact stomach were served as control group. Patients in remnant stomach A group were given esomeprazole 20 mg bid+amoxicillin 1000 mg bid+furazolidone 100 mg bid (EAF regimen) for 10 days. Patients in remnant stomach B group were given the EAF regimen for 10 days and kept at lying on the left side for 30 min after taking the drugs. Patients in control group were given the EAF regimen for 10 days. Three months after treatment, rapid urease test and microscopic examination of stained gastric mucosal tissue section were performed to assess Hp eradication. Gastroscopy was applied before and 3 months after treatment, the updated Sydney System visual analogue scales were used for grading the histopathologic features. Hp eradication rate in remnant stomach A group was significantly lower than that in control group by intention-to-treat (ITT) and per protocol (PP) analysis (P<0.05). Eradication rate in remnant stomach B group was higher than that in remnant stomach A group by ITT and PP analysis but not reaching statistical significance (P>0.05). Eradication rate between remnant stomach B group and control group was not significantly different by ITT and PP analysis (P>0.05). There was no correlation between Hp eradication rate and method of reconstruction (Billroth I or Billroth II) (P>0.05). After treatment, inflammation and activity scores were significantly decreased in the three groups (P<0.01), but no significant differences were found in glandular atrophy and intestinal metaplasia scores (P>0.05). Incidence of adverse effects was not significantly different between the three groups (P>0.05), and no serious adverse effects were seen. Triple therapy (EAF regimen) combined with posture change (keeping at lying on the left side for 30 min) after taking medicine is a safe and effective measure for eradication of Hp in remnant stomach.