4. Discussion
ADVERSE REACTIONS, ADVERSE EFFECTS, GROUP B, ADVERSE EFFECTS, SECONDARY
According to this study, the eradication rate of vonoprazan combined with high-dose amoxicillin in groups A and B was similar, without statistical difference, and both were better than the current mainstream regimen: quadruple therapy. From the study of adverse reactions, from ITT analysis, there was no significant difference in adverse reactions between groups A and B; There was a statistical difference between groups A and C (Meta-analysis showed that 3 doses of amoxicillin per day improved eradication rates compared to the traditional 2 doses per day at the same total amoxicillin dose. The optimal therapeutic dose of amoxicillin is 3 grams per day, and the frequency of 3 doses per day improves the eradication rate.Vonoprazan is mainly metabolized by the hepatic microsomal enzyme Cytochrome P4503A4 enzymes and is not affected by Cytochrome P450, family 2, subfamily C, polypeptide 19 gene polymorphism, while vonoprazan has a long plasma half-life and remains stable in an acidic environment, so it can stay in the secretory tubules for a long time and can inhibit both resting and activated state proton pumps by binding to H+/K+-ATPase through ionic and hydrogen bonds.Adverse effects are also an important indicator for assessing the rationality of the treatment program. In the ITT analysis, we observed that there was no statistically significant difference in adverse reactions between groups A and B, a statistically significant difference between groups A and C, and a statistically significant difference between groups B and C. Group B had a better safety profile among the 3 groups.Literature shows that smoking leads to a further decrease in the pH value in the stomach. Secondly, nicotine also reduces the blood flow to the gastric mucosa, reducing the bactericidal effect of antibiotics. At the same time, it is difficult for smoking patients to quit smoking, which makes it impossible to quit smoking during the treatment period and makes it difficult to eradicate In recent years, primary and secondary antibiotic resistance of In conclusion, there is no significant difference between group B eradication therapy and group A eradication therapy, and it is better than the current mainstream quadruple therapy, and there is no significant difference between group B and group A adverse effects, and it has higher safety than group C, and eradication of 