含益生菌四联疗法根除幽门螺杆菌的临床疗效

来源期刊：广州医药 | 38-41 发布时间：2021-12-01 收稿时间：2025/11/13 17:15:22 阅读量：144

作者：: 容海鹰,

沙卫红,

聂玉强,

杨元生,

李锐清,

朱雅丽,

张明,

彭卫斌,

关键词：: 益生菌幽门螺杆菌三联疗法四联疗法消化性溃疡; Probiotics Helicobacter pylori Triple therapy Quadruple therapy Peptic ulcer

DOI：: 10.3969/j.issn.1000-8535.2017.01.010

收稿时间：: 2016-11-14
修订日期：
接收日期：
引用总数：: 0

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.

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