益生菌联合含呋喃唑酮四联疗法根除幽门螺杆菌的疗效

Therapeutic effect of probiotics combined with furazolidone quadruple therapy for eradication of Helicobacter pylori

目的分析益生菌联合含呋喃唑酮四联疗法根除幽门螺杆菌(Helicobacter pylori,Hp)的疗效。方法选取2022-03至2022-10两批次驻吉林某部入伍新兵共计Hp阳性感染者403例,按随机数字表法分为对照组(201例)及观察组(202例)。对照组治疗药物:雷贝拉唑肠溶胶囊,20 mg/次,2次/d,早晚饭前服用;阿莫西林1000 mg/次,2次/d,早晚饭后服用;呋喃唑酮0.1 g/次,2次/d,早晚饭后服用;胶体果胶铋胶囊200 mg/次,2次/d,早晚饭前服用,疗程14 d。观察组在上述四联药物基础上加用益生菌(双歧杆菌四联活菌片),3片/次,3次/d。停药4周后复查^(13)C呼气试验,评估Hp根除率,同时对治疗中出现的不良反应进行监测汇总。结果按ITT分析对照组根除率为88.06%,观察组为87.13%,两组差异无统计学意义(χ^(2)=0.080,P=0.777)。按PP分析两组根除率,对照组为88.06%,观察组为87.56%,差异无统计学意义(χ^(2)=0.023,P=0.879)。两组不良反应发生率对照组为14.52%,观察组为8.91%,差异有统计学意义(χ^(2)=4.000,P=0.045)。结论益生菌联合呋喃唑酮四联疗法能降低不良反应发生率,但对根除率无明显提升。

Objective To analyze the effect of probiotics combined with furazolidone quadruple therapy on eradication of Helicobacter pylori(Hp).Methods A total of 403 Hp-positive new recruits were selected from two batches from March to October 2022 and were divided into control group and observation group using a random number table.The control group received rabeprazole entericcoated capsules at a dose of 20 mg,twice daily before breakfast and dinner,amoxicillin at a dose of 1000 mg,twice daily after breakfast and dinner,furazolidone at a dose of 0.1 g,twice daily after breakfast and dinner,and colloidal bismuth pectin capsules at a dose of 200 mg,twice daily before breakfast and dinner.The treatment duration was 14 days.The observation group received the same quadruple therapy plus probiotics(bifidobacterium quadruple active tablets)at a dose of 3 tablets,three times daily.After a 4-week drug withdrawal,the^(13)C breath test was conducted to evaluate the Hp eradication rate.Adverse reactions during treatment were monitored and summarized for statistical analysis.Results The Hp eradication rate in the control group was 88.06%(ITT analysis)and 87.13%(ITT analysis)in the observation group,with no statistically significant difference between the two groups(χ^(2)=0.080,P=0.777).The PP analysis showed eradication rates of 88.06%in the control group and 87.56%in the observation group,with no statistically significant difference(χ^(2)=0.023,P=0.879).The incidence of adverse reactions was 15.4%in the control group and 8.9%in the observation group,with a significant difference in the occurrence of adverse reactions(χ^(2)=4.000,P=0.045).Conclusions Probiotics combined with furazolidone quadruple therapy can reduce the incidence of adverse reactions,but do not significantly improve the eradication rate.