幽门螺杆菌治疗中抗生素相关性腹泻的预防

Prevention of Antibiotic-associated Diarrhea Induced by Eradication Therapy of Helicobacter pylori Infection

目的探讨双歧三联活菌胶囊(培菲康)对根除幽门螺杆菌(HP)治疗中所致抗生素相关性腹泻(AAD)的预防作用。方法将128例HP阳性的胃及十二指肠溃疡患者随机分成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);两组抗生素疗程均为2周,奥美拉唑及果胶铋疗程为4周;抗生素治疗结束4周后复查13C-尿素呼气试验及尿素酶试验,判断根除HP疗效。结果A、B组两组根除HP效果相近,根除率分别为92.19%和96.88%(P>0.05);AAD发生率B组明显低于A组(P<0.05),>60岁患者AAD发生率明显高于<60岁患者(P<0.05)。结论老年人AAD发生率高,培菲康能有效防治根除HP感染治疗中引起的AAD。

OBJECTIVE To investigate the effect of prevention of the Peifeikang capsule on antibiotic associated diarrhea （AAD） induced by eradication therapy of Helicobacter pylori infection. METHODS The 128 patients with peptic ulcer （gastric ulcer or duodenal ulcer）, in whom results were both positive for the ^13C-urea breath test and rapid urease test, were divided into two groups randomly, ie, group A （amoxicillin/metronidazole/colloidal bismuth subcitrate/omeprazole） and group B （amoxicillin/metronidazole/colloidal bismuth subcitrate/omeprazole ＋ Peifeikang capsule）. The effect on eradication of H. pylori was determined by the ^13C-urea breath test and the rapid urease test again four weeks later after finishing cure. RESULTS The eradication rate of both groups was approximate, 92.19% and 96.88%, respectively （P〈0. 05）. The morbidity of AAD was obviously lower in group B than that in group A （P〈0.05）. The morbidity of AAD among patients more than 60 years old was higher than that of less than 60 years old （P〈0. 05）. CONCLUSIONS The morbidity of AAD is higher in the elders; Peifeikang capsule can prevent AAD induced by eradication therapy of H. pylori infection.