抗藥性的產生使得以三合一療法為基礎的幽門螺旋桿菌滅菌率大幅降低。感染幽門螺旋 桿菌的滅菌失敗率高達四分之一。本研究的目的是評估非潰瘍性消化不良的病人接受階段療 法治療的滅菌率。自2005年2月至2009年5月，我們共收集了174例（女：63%；年齡：50.0 ± 10.8歲）經上消化道攝影或上消化道內視鏡證實為非潰瘍性消化不良。每個病人接受為 期10天的階段療法包括前五天40毫克pantoprazole，amoxicillin 1克每日兩次，接下來五天40 毫克pantoprazole，clarithromycin 500毫克，tinidazole 500毫克的滅菌療程。完成治療後至少2 個月後以尿素呼氣試驗、快速尿素試驗或組織學證實是否滅菌成功。根除率以per-protocol 及 intention-to-treat來計算。我們也用多變異數回歸模型來評估年齡、性別和成功率根除之 間的關係。在164個返回追蹤試驗的病患中有148人成功治癒。因此，per-protocol的治癒率為 90.2%，而intention-to-treat計算的治療根除率相對較低，為80.2%。階段療法在南歐國家證實 能有效治療幽門螺旋桿菌感染相關的消化性潰瘍。在這項研究中，階段療法證實對於台灣的 消化不良患者是有效且耐受性佳的療法。

Antimicrobial resistance has decreased PPI-based triple therapy for eradication of H. pylori. The failure rate is almost one quarter of patients with H. pylori infection. The objective of this study was to assess the eradication rate and acceptance of sequential therapy for patients with non-ulcer dyspepsia (NUD). From February 2005 to May 2009, we enrolled 174 patients (Female: 62%; Age: 50.3±10.5 yr) with investigated (EGD or UGI series) NUD. Each patient adopted a 10-day sequential regimen consisting of 40 mg of pantoprazole, 1 g of amoxicillin twice daily for the first 5 days followed by 40 mg of pantoprazole, 500 mg of clarithromycin, and 500 mg of tinidazole twice daily for the remaining 5 days. Eradication was confirmed at least two months after completion of treatment by means of UBT, rapid urease test or histology. Eradication rates were calculated per-protocol and by intention-to-treat. We also used multiple regression models to assess the relationship between age, gender and success rate of eradication. Eradication was achieved in 138 out of 152 who returned for a follow-up test. Thus, the per-protocol cure rate was 90.8 %, while intention-to-treat eradication rate was relatively low at 80.2 %. Sequential therapy has proven effective in treating ulcer-related H. pylori infection in Southern Europe. In this study, sequential therapy proved effective and well-tolerated for ethnic Chinese NUD patients as well. ( J lntern Med Taiwan 2010; 21: 125-132 )