Abstract
OBJECTIVE: To evaluate the eradication effect of dual therapy based on rabeprazole or vonoprazan for Helicobacter pylori (Hp) infection. METHODS: Data from 300 Hp-positive patients were retrospectively analyzed. Patients who received rabeprazole and amoxicillin were assigned to the rabeprazole group, those who received vonoprazan and amoxicillin were placed in the vonoprazan group, and those who underwent conventional quadruple therapy (omeprazole + amoxicillin + clarithromycin + bismuth potassium citrate) were included in the control group. Clinical medical records, including baseline characteristics, symptom manifestations, examination results, treatment regimens, and treatment costs, were collected. The Hp eradication rate, symptom relief, levels of inflammatory markers (interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP)), incidence of adverse reactions, treatment compliance, and cost-effectiveness ratio (C/E) were compared among the three groups. RESULTS: In both per-protocol (PP) and intention-to-treat (ITT) analyses, no statistically significant differences were observed in eradication rates among the three groups (P>0.05). Symptom relief was more pronounced at 44 days of treatment compared to 14 days across all groups (P<0.05). At both 14 and 44 days, significant differences were found in the relief of abdominal distension (14 days: Z=20.644, P<0.001; 44 days: Z=11.577, P=0.003) and belching (14 days: Z=23.234, P<0.001; 44 days: Z=20.194, P<0.001) among the three groups (P<0.05), with the rabeprazole group showing the best improvement, followed by the control group. After treatment, the IL-6, TNF-α, and CRP levels in the rabeprazole and vonoprazan groups were lower than those in the control group (all P<0.05). There was no significant difference in treatment compliance among the three groups (χ(2)=0.224, P=0.894). The C/E was lowest in the rabeprazole group and highest in the vonoprazan group. CONCLUSION: Dual therapy based on rabeprazole or vonoprazan effectively improves symptoms in patients with Hp infection, with relatively few adverse reactions and good treatment compliance. Additionally, rabeprazole-based dual therapy had a lower cost.