含益生菌四联疗法根治顽固性幽门螺杆菌感染的疗效观察

Radical curative efficacy of quadruple therapy containing probiotics on persistent Helicobacter pylori infection: an efficacy observation

目的探讨含益生菌四联疗法根治顽固性幽门螺杆菌感染(H.pylori)的疗效。方法经标准三联疗法根治失败的顽固性幽门螺杆菌感染患者180例,随机分为6组:A组(含双歧杆菌乳杆菌三联活菌片四联疗法):雷贝拉唑+阿莫西林+克拉霉素+双歧杆菌乳杆菌三联活菌片;B组(伴同疗法):雷贝拉唑+阿莫西林+克拉霉素+呋喃唑酮;C组(标准四联疗法):雷贝拉唑+阿莫西林+克拉霉素+胶体果胶铋。疗程均为7 d。同样分组方案A1组、B1组、C1组,疗程14 d。治疗前后查肝肾功及三大常规,观察药物不良反应。1个月后复查胃镜并作快速尿素酶实验及14C呼吸实验(14C-UBT),观察H.pylori根除情况。结果含双歧杆菌乳杆菌三联活菌片四联疗法根除率7 d为76.7%,与其他两组比较差异无统计学意义(P>0.05),无任何不良反应发生;14 d为90.0%,与其他两组比较差异也无统计学意义(P>0.05),各组均优于7天组(P<0.05);14天组不良反应发生率为6.67%,7天及14天组不良反应均低于其他相应各组。结论含双歧杆菌乳杆菌三联活菌片四联疗法根治顽固性幽门螺杆菌感染的疗效与标准四联及伴同疗法相当,但不良反应较少,可以值得推广。

Objective To Discuss the radical curative efficacy of probiotic-containing quadruple therapy on persistent Helicobacter pylori infection.Methods 180 patients with intractable Helicobacter pylori infection after failure of triple therapy were randomly divided into 6 groups： Group A（Quadruple therapy of Live Combined Bifidobacterium and Lactobacillus Tablets） was given Rabeprazole ＋ Amoxicillin ＋ Clarithromycin ＋ Live Combined Bifidobacterium and Lactobacillus Tablets;Group B（Concomitant therapy） was given Rabeprazole ＋ Amoxicillin ＋ Clarithromycin ＋ Furazolidone;Group C（Standard quadruple therapy） was given Rabeprazole ＋ Amoxicillin ＋ Clarithromycin ＋ Colloidal Bismuth Pectin.The course of treatment was 7 days.The same grouping scheme was applied to groups A1,B1 and C1,except that the course of treatment was 14 days.Observation was performed on liver and kidney functions and results of three routine tests before and after treatment,as well as adverse drug reactions.After one month,gastroscope,rapid urease test and 14C-UBT were conducted to observe the eradication of Helicobacter pylori.Results The eradication rate of Group A was 76.7%,with no significant difference from the other two groups（P0.05）;no adverse reactions were observed;The eradication rate of Group A1 was 90.0% with no significant difference from the other two groups（P0.05）.The results of 14-day groups were better than those of the 7-day groups（P0.05）;The incidences of adverse reaction were 6.67% in 7-day groups and group A1,lower than those of the other groups.Conclusion The quadruple therapy containing Live Combined Bifidobacterium and Lactobacillus Tablets for eradication of persistent Helicobacter pylori infection has a comparative efficacy to that of Standard quadruple therapy or Concomitant therapy,but with fewer adverse reactions,and is worth promoting.