Boulardii酵母菌联合三联及四联疗法根治幽门螺杆菌的疗效及对不良反应改善情况的研究

Research on the effect and adverse drug reaction of Boulardii yeast combined triple and quadruple therapy on eradicating helicobacter pylori

目的评价Boulardii酵母菌联合三联及四联疗法根治幽门螺杆菌（H.pylori）的疗效及对不良反应的改善情况。方法选取2014年1月~2015年12月本院收治的H.pylori阳性的消化性溃疡患者240例,根据治疗方法不同将其分为三联组（60例）、三联联合组（60例）、四联组（60例）与四联联合组（60例）。三联组给予克拉霉素＋阿莫西林＋潘托拉唑治疗;三联联合组在上述标准三联治疗基础上加用Boulardii酵母菌;四联组给予克拉霉素＋阿莫西林＋潘托拉唑＋CBS胶囊治疗,四联联合组在上述标准四联治疗基础上加用Boulardii酵母菌。4组均连续治疗14天,在治疗后第5周进行14C-UBT复查,并对各组H.pylori根除率、药物不良反应情况进行比较。结果与三联组、四联组比较,三联联合组与四联联合组H.pylori根除率（91.2%、94.7%）明显提高,不良反应发生率（31.6%、29.8%）明显降低,H.pylori累积复发率明显降低,差异均具有统计学意义（P〈0.05）。结论 Boulardii酵母菌联合三联及四联疗法能明显提高H.pylori根除率,降低不良反应发生率及复发风险,可根据实际情况合理选择治疗方案。

Objective To evaluate the effect and adverse drug reaction of Boulardii yeast combined with triple and quadruple therapy on eradication helicobacter pylori （H.pylori）.Methods240 cases of peptic ulcer patients of H.pylori positive were selected in our hospital from January 2014 to December 2015, according to different treatment were divided into the triple threapy group（n=60）, the triple therapy union group （n=60）, the quadruple therapy group （n=60） and the quadruple therapy union group （n=60）.The triple threapy group were given clarithromycin and amoxicillin and pantoraazole;on the basis of this, the triple therapy union group were given Boulardiiyeast.the quadruple therapy group were given clarithromycin and amoxicillin and pantoraazole and CBS capsule, on the basis of this, the quadruple therapy union group were given Boulardiiyeast.The four groups were treated continuously for 14 days.14C-UBT, H.pylori eradication rate and adverse drug reaction in the four groups were evaluated five weeks after treatment.ResultsCompared with the triple threapy group and the quadruple therapy group, H.pylori eradication rate in the triple therapy union group（91.2%） and the quadruple therapy union group（94.7%） were improved obviously, and the adverse drug reactions （31.6%、29.8%） decreased significantly, the cumulative recurrence rate of H.pylori were significantly decreased, and the differences were statistically significant （P〈 0.05）.ConclusionBoulardii yeast combined with triple and quadruple therapy can obviously increase the H.pylori eradication rate, reduce the incidence of adverse drug reactions and the risk of recurrence.The reasonable treatment plan should be selected according to the actual situation.