双歧杆菌乳杆菌三联活菌辅助治疗Hp阳性慢性浅表性胃炎患者的疗效评价

Efficacy evaluation of Bifidobacterium and Lactobacillus triple viable bacteria in adjuvant treatment of patients with Helicobacterpylori positive chronic superficial gastritis

目的分析双歧杆菌乳杆菌三联活菌辅助治疗幽门螺杆菌(Hp)阳性慢性浅表性胃炎(CSG)患者的临床效果。方法选取2019-11-15-2021-7-15太康县中医院就诊的Hp阳性CSG患者128例,根据性别、年龄、病程等因素组间平衡的原则分组,分为研究组(n=64)和常规组(n=64)。常规组采用雷贝拉唑四联疗法治疗,口服雷贝拉唑钠肠溶胶囊,20 mg/次,3次/d;口服阿莫西林胶囊,0.5 g/次,3次/d;口服克拉霉素胶囊,0.5 g/次,3次/d;口服枸橼酸铋钾胶囊,0.3 g/次,2次/d。研究组在常规组基础上口服双歧杆菌乳杆菌三联活菌,2 g/次,3次/d,2组均连续治疗2周;比较2组疗效、临床症状消失时间、不良反应情况及Hp根除率,治疗前后病情相关指标[白介素-6(IL-6)、白介素-10(IL-10)、白介素-17(IL-17)、白介素-8(IL-8)、转化生长因子β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)],经调查收集、血常规检测收集上述数据,收集的计量资料以x±s表示,存在多个时间点数据采用单因素协方差分析,计数资料用n(%)表示、χ^(2)检验。结果研究组总有效率为96.88%(62/64),高于常规组81.25%(52/64),差异有统计学意义,χ^(2)=8.020,P=0.005;研究组腹部隐痛消失时间为(4.27±0.84)d,短于常规组(7.61±1.25)d,差异有统计学意义,t=17.742,P<0.001;反酸消失时间为(3.96±1.24)d,短于常规组(6.87±1.36)d,差异有统计学意义,t=12.649,P<0.001;嗳气消失时间为(4.16±1.14)d,短于常规组(7.13±1.59)d,差异有统计学意义,t=12.144,P<0.001;上腹不适消失时间为(4.62±1.09)d,短于常规组(7.83±1.39)d,差异有统计学意义,t=14.538,P<0.001;研究组Hp根除率为95.31%(61/64),高于常规组78.13%(50/64),差异有统计学意义,χ^(2)=8.208,P=0.004;研究组不良反应总发生率为1.56%(1/64),低于常规组9.38%(6/64),差异无统计学意义,χ^(2)=2.418,P=0.120;根据治疗前调整后,治疗后与常规组比较,研究组IL-6、IL-17、IL-8、TGF-β1、TNF-α较低,IL-10较高,差异有统计学意义,均P<0.05。结论双歧杆菌乳杆菌三联活菌辅助治疗Hp阳性CSG患者可有效清除体内Hp,改善患者临床症状,还可抑制机体炎症及氧化应激损伤,临床疗效确切。

Objective To analyze the clinical effect of Bifidobacterium Lactobacillus triple viable bacteria in adjuvant treatment of Helicobacter pylori(Hp)positive chronic superficial gastritis(CSG).Methods A total of 128 Hp-positive CSG patients who were treated in Taikang County Traditional Chinese Medicine Hospital from 2019-11-15to 2021-7-15were selected and divided into study group(n=64)and the conventional group(n=64).The routine group was treated with rabeprazole quadruple therapy,oral rabeprazole sodium enteric-coated capsules,20 mg/time,3times/d;oral amoxicillin capsules,0.5g/time,3times/d;oral clathrate Mycin capsules,0.5g/time,3times/d;oral bismuth potassium citrate capsules,0.3 g/time,2times/d.On the basis of the routine group,the study group was given oral administration of Bifidobacterium Lactobacillus triple viable bacteria,2g/time,3times/d,and both groups were treated continuously for 2weeks;The curative effect,clinical symptom disappearance time,adverse reactions and Hperadication rate,disease-related indicators before and after treatment[interleukin-6(IL-6),interleukin-10(IL-10),interleukin-17(IL-17),interleukin-8(IL-8),transforming growth factorβ1(TGF-β1),tumor necrosis factor-α(TNF-α)],oxidative stress indicators[malondialdehyde(MDA),glutathione peroxidation Bio-enzyme(GSH-PX),superoxide dismutase(SOD)]were compared between the two groups.The above data were collected through investigation and blood routine testing.The collected measurement data were expressed as x-±s,and there were multiple time points data using one-factor covariance analysis,the counting data were expressed with n(%),andχ^(2)test was performed.Results The total effective rate of the research group was 96.88%(62/64),which was higher than that of the routine group,81.25%(52/64),with a statistically significant difference,χ^(2)=8.020,P=0.005;the disappearance time of abdominal pain in the research group was(4.27±0.84)d,shorter than that of the routine group(7.61±1.25)d,the difference was statistically significant,t=17.742,P<0.001;the disappearance time of acid reflux was(3.96±1.24)d,shorter than that of the routine group(6.87±1.36)d,the difference was statistically significant,t=12.649,P<0.001;the disappearance time of belching was(4.16±1.14)d,shorter than that of the routine group(7.13±1.59)d,the difference was statistically significant,t=12.144,P<0.001;the disappearance time of epigastric discomfort was(4.62±1.09)d,which was shorter than that of the routine group(7.83±1.39)d,and the difference was statistically significant,t=14.538,P<0.001;the eradication rate of Hpin the study group was 95.31%(61/64),higher than that of the routine group of 78.13%(50/64),the difference was statistically significant,χ^(2)=8.208,P=0.004;the total incidence of adverse reactions in the study group was 1.56%(1/64),lower than that of the routine group of 9.38%(6/64),the difference was not statistically significant,χ^(2)=2.418,P=0.120;According to adjustment before treatment,IL-6,IL-17,IL-8,TGF-β1,TNF-αin the study group were lower,but IL-10was higher,compared with the conventional group after treatment,the difference was statistically significant,all P<0.05.Conclusion Bifidobacterium Lactobacillus triple viable bacteria assignment in the treatment of Hp-positive CSG patients can effectively remove Hpin the body,improve the clinical symptoms of the patients,and also inhibit the body’s inflammation and oxidative stress damage,with definite clinical effect.