目的 探讨含双歧杆菌乳杆菌三联活菌新四联疗法对消化性溃疡患者幽门螺杆菌(Helicobacter pylori, Hp)根除治疗中的疗效。方法 将342例Hp阳性的消化性溃疡患者随机分为三个治疗组:A组(三联疗法)、B组(含铋剂四联疗法)及C组(含益生菌四联疗法),疗程均2周。疗程结束4周后复查¹³C-尿素呼气试验评估根除疗效。治疗期间记录患者不良反应发生情况。结果 300例(87.72%)患者按方案完成治疗,A、B及C组治疗完成率分别为85.71%(96/112)、82.50%(99/120)和95.45%(105/110),C组显著高于A及B组(P＜0.05)。在胃溃疡Hp根除率比较中,按意愿(方案)分析,A、B及C组疗法的Hp根除率分别为64.71%(75.86%)、71.43%(85.71%)及84.38%(87.10%),各组间差异无统计学意义(P均>0.05)。在十二指肠球部溃疡Hp根除率比较中,按意愿(ITT)分析,C组(85.90%)明显高于A组(62.82%)及B组(71.79%),差异有统计学意义(χ²=10.893,P=0.001;χ²=4.650,P=0.031);按方案(PP)分析,B组(87.50%)与C组(90.54%)明显高于A组(73.13%),差异有统计学意义(χ²=4.246,P=0.039;χ²=7.304,P=0.007),但B组与C组之间差异无统计学意义(P<0.05)。胃肠道不良反应中,便秘、味觉异常及腹胀的发生率,含益生菌疗法组明显少于另两组,差异有统计学意义(P均<0.05)。结论 含双歧杆菌乳杆菌三联活菌新四联疗法能够显著降低传统三联及四联根除疗法的胃肠道不良反应,提高患者依从性,从而提高消化性溃疡患者Hp的根除率。

Objective To investigate the efficacy of quadruple therapy containing bifidobacterium and lactobacillus triple live bacteria on eradication of Helicobater pylori (Hp) among the patients with peptic ulcer. Methods 342 Hp-infected peptic ulcer patients were randomly divided into three groups:A, B and C. The patients in group A were treated with standard triple therapy. The patients in group B and group C were treated with Colloidal Bismuth Subcitrate and Bifidobacterium and Lactobacillus combined with standard triple therapy, respectively. All patients in three groups were treated for 14 days. In the 4th week after end of treatment, Hp eradication was assessed by ¹³C-urea breath test. Adverse effects during the course of treatment were recorded. Results A total of 300(87.72%) patients completed the treatment. The completion rates in group A, B and C were 85.71%(96/112), 82.50%(99/120) and 95.45%(105/110) respectively, and the completion rate in group C were significantly higher than that in group A and group B(P<0.05). With intention to treat and per-protocol analysis in gastric ulcer, the eradication rates of group A, B and C were 64.71%(75.86%), 71.43%(85.71%)and 84.38%(87.10%) respectively, but there were not significant difference in the three groups(P>0.05). With intention to treat analysis in duodenal ulcer, the Hp eradication rate in group C was 85.90%, which was significantly higher than that in group A (62.82%;χ²=10.893,P=0.001) and in group B (71.79%;χ²=4.650,P=0.031). With per-protocol analysis in duodenal ulcer, the Hp eradication rate was 90.54% in group C and 87.50% in group B. No Obviously difference was found between group B and group C (P<0.05), but both were higher than that in group A(73.13%) (χ²=4.246,P=0.039;χ²=7.304,P=0.007). The incidence of adverse reactions including constipation, taste distortion and bloating in group C were significantly lower than those in the other two groups (P<0.05). Conclusion The quadruple therapy containing bifidobacterium and lactobacillus triple live bacteria can obviously enhance the patient's compliance and decrease the adverse reactions, thereby may increase the Hp eradication rate among the patients with peptic ulcer.

       人工智能（AI）这一新兴技术的出现和应用给炎症性肠病（IBD）的诊断带来了巨大的变革。越来越多的研究着手于开发基于机器学习（ML）和深度学习（DL）的诊断模型，并获得了良好的诊断性能，尤其是在IBD的图像诊断，卷积神经网络（CNN）等模型由于其出色的图像分析能力，在内镜检查和组织病理检查等方面具有十分可观的发展前景。近年来AI诊断模型的应用越发广泛，但与此同时，关于算法、数据库及其应用方面仍存在一些难以忽视的局限性。本文将主要就图像识别方面对AI在IBD诊断中的应用进行综述，以期为IBD精准图像诊断领域下步研究提供参考。

        As an emerging technology，artificial intelligence（AI）has brought great changes to the precise diagnosis of inflammatory bowel disease（IBD）．More and more  researches have developed diagnostic models which are based on machine learning（ML）and deep learning（DL）and obtained satisfactory diagnostic performance．Especially in the image  diagnosis of IBD，convolutional neural network（CNN）and  other models  have  considerable  development  prospects in  endoscopy  and histopathology due to their excellent image analysis capabilities．In recent years，the application of AI diagnostic models has become more and more widespread，but at the same time，there are still some limitations about algorithms，databases and their applications that cannot be ignored．This review mainly focused on the application of AI in IBD diagnosis from the aspect of image recognition，to provide a reference for IBD diagnosis towards precision medicine．