老年人抗生素相关性肠道菌群失调的防治

Control of intestinal flora alteration induced by eradication therapy of helicobacter pylori infection in the elders

目的观察肠道微生态调节剂培菲康胶囊对老年人抗生素相关性肠道菌群失调的防治作用。方法将幽门螺杆菌(Helicobacterpylori)感染的十二指肠溃疡及胃溃疡患者随机分至A组(阿莫西林、甲硝唑、奥美拉唑、果胶铋四联治疗组)和B组(四联加培菲康治疗组) ,疗程均为2周,治疗结束4周后复查13 C 尿素呼气试验及快速尿素酶试验判断根除H pylori疗效。依据腹泻症状、粪便常规及镜检结果判定肠道菌群失调。结果A、B两组疗法均有较理想根除H pylori疗效,根除率分别为92 19%、96 88% ,两组比较差异无显著性(P >0 0 5 )。单纯四联治疗组抗生素相关性肠道菌群失调发生率明显高于四联加培菲康组(P <0 0 5 )。A组中5 5岁以上患者肠道菌群失调发生率( 3 5 2 9% )明显高于5 5岁以下患者( 12 77% ,P <0 0 5 ) ;与A组比较,B组老年患者肠道菌群失调发生率明显下降( 10 5 3 % ,P <0 0 5 )。结论培菲康胶囊能有效地防治老年人根除HP治疗所致抗生素相关性肠道菌群失调的发生。

Objective To observe the effect of the PEIFEIKANG capsule on alteration of intestinal flora (AIF) induced by eradication therapy of Helicobacter pylori infection in the elders.Methods The 128 patients with peptic ulcer (86 duodenal ulcer and 42 gastric ulcer), which both were positive for the^13 C-urea breath test and rapid urease test, were divided into two groups randomly, i.e, group A (amoxicillin, metronidazole, colloidal bismuih subcitrate, omeprazole) and group B (amoxicillin, metronidazole, colloidal bismuih subcitrate, omeprazole and PEIFEIKANG capsule). Curative effect was determined by the^13 C-urea breath test and the rapid urease test again after treatment(4 weeks). Generation of AIF was determined by feces routine and bacteriological test.Results Both two groups had ideal effect on eradication of Helicobacter pylori infection (eradication rate was 92.19% and 96.88%, respectively,P>0.05 ). Generation rate of AIF was lower in group B(4.69%) than that of group A(18.75%) (P<0.05). Generation rate of AIF in the group A of more than 55 years older group(35.29%) was higher than that of group of less than 55 years older(12.77%) (P<0.05). Compare with group A, generation rate of AIF declined obviously in the elders in group B (10.53%,P<0.05). Conclusion PEIFEIKANG capsule can control the AIF induced by eradication therapy of Helicobacter pylori infection in the elders.