【摘要】背景  2009年日本幽门螺杆菌研究学会(JSHＲ)指南将“幽门螺杆菌感染”定为适应证，因此自2013年起日本将幽门螺杆菌性胃炎根除治疗纳入医疗保险，根除幽门螺杆菌病例数量迅速增加。在这种情况下，JSHＲ 7 年来首次对《幽门螺杆菌感染诊断和治疗指南》进行了第三次修订。方法  通过JSHR指导委员会举行的10次会议，将2009年指南制定开始至2016年3月发表的文章根据证据级别进行了审查和分类;在本次审查的基础上对声明进行了修订。在征求公众意见后，采用德尔菲法最终确定了修订后的指南。结果 幽门螺杆菌感染属于感染性疾病，根除幽门螺杆菌的基本方针未改变。其他被认为与幽门螺杆菌感染有关的疾病被作为适应证添加。增加了血清胃蛋白酶原水平、内镜检查、X 射线检查等诊断方法。由钾竞争性酸阻滞剂(P-CAB)、阿莫西林和克拉霉素组成的1周三联疗法的效果有所改善，质子泵抑制剂(PPI)或P-CAB联合阿莫西林和甲硝唑也期望有较高的根除率。如果不进行敏感性试验，则应选择三联PPI或P-CAB/阿莫西林/甲硝唑治疗，因为PPI/阿莫西林/甲硝唑联合治疗的根除率明显高于PPI/阿莫西林/克拉霉素。在胃癌预防方案中，我们按年龄从青少年到老年提供了胃癌预防措施，这些年龄段的人群胃癌风险增加，并提出了基于根除幽门螺杆菌的胃癌预防措施。结论 我们期望修订后的指南能够为幽门螺杆菌感染患者提供适当的干预措施，并完成根除和预防胃癌的工作。

【Abstract】 Background Since“Helicobacter pylori (H. pylori) infection”was set as the indication in the Japanese Society for Helicobacter Research (JSHR) Guidelines 2009, eradication treatment for H. pylori gastritis is covered under insurance since 2013 in Japan, and the number of H. pylori eradication has rapidly increased. Under such circum-stances, JSHR has made the third revision to the“Guidelines for diagnosis and treatment of H. pylori infection”for the first time in 7 years. Methods The Guideline Committee held 10 meetings. Articles published between the establish-ment of the 2009 Guidelines and March 2016 were reviewed and classified according to the evidence level; the state-ments were revised on the basis of this review. After inviting public comments, the revised statements were finalizedusing the Delphi method. Results There was no change in the basic policy that H. pylori infectious disease is an indica-tion for eradication. Other diseases presumed to be associated with H. pylori infection were added as indications. Serum pepsinogen level, endoscopic examination, and X-ray examination were added to the diagnostic methods. The effects of 1-week triple therapy consisting of potassium-competitive acid blocker (P-CAB), amoxicillin, and clarithromycin have improved，and high eradication rates can also be expected with proton pump inhibitors (PPI) or P-CAB combined with amoxicillin and metronidazole. If the susceptibility test is not performed, the triple PPI or P-CAB/amoxicillin/ metron-idazole therapy should be chosen, because the PPI/amoxicillin/metronidazole combination demonstrated a significantly higher eradication rate than PPI/amoxicillin/clarithromycin. In the proposal for gastric cancer prevention，we divided gastric cancer prevention measures by age from adolescent to elderly, who are at an increased gastric cancer risk, and presented measures for gastric cancer prevention primarily based on H. pylori eradication. Conclusion We expect the revised guidelines to facilitate appropriate interventions for patients with H. pylori infection and accomplish its eradication and prevention of gastric cancer.