不同益生菌联合铋剂四联疗法根除幽门螺杆菌疗效观察

Curative effect observation of quadruple therapy in combination with different probiotics in treatment of anti-H.pylori

(1)目的探讨不同益生菌联合铋剂四联疗法对幽门螺杆菌(H.pylori)根除疗效的影响。(2)方法选择内镜下快速尿素酶试验或^(14)C-UBT确诊H.pylori阳性患者120例,随机分成四组。A组:铋剂四联疗法(雷贝拉唑钠、阿莫西林、克拉霉素、枸橼酸铋钾);B组:铋剂四联疗法加用双歧三联活菌片;C组:铋剂四联疗法加用凝结芽孢杆菌活菌片;D组:铋剂四联疗法加用布拉酵母菌散。四组用药均10天。记录患者在服药过程中出现不良反应的情况,并于停药4周后复查^(14)C-UBT。(3)结果 B组、D组H.pylori根除率显著高于A组,差异有统计学意义(P<0.05)。C组根除率高于A组,但差异无统计学意义(P>0.05);B组、C组、D组的不良反应发生率均显著低于A组(P<0.05)。B、C、D三组间根除率及不良反应发生率差异均无统计学意义(P>0.05)。(4)结论双歧三联活菌、布拉酵母菌均可提高H.pylori根除率并降低不良反应的发生率;凝结芽孢杆菌虽不能提高H.pylori的根除率,但可有效降低不良反应的发生。

Objective To explore the efficacy of different types of probiotics combined with bis- muth quadruple therapy for eradication of Helicobacter pylori （H.pylori）.Methods A total of 120 pa- tients with positive H. pylori infection diagnosed by rapid urease test or 14C urea breath test were ran- domly divided into four groups. Group A-received bismuth quadruple therapy （rabeprazole,amoxicil- lin,clarithromycin, bismuth potassium citrate） for 10 days. Group B received bismuth quadruple thera- py plus bifid triple viable capsules for 10 days. Group C received bismuth quadruple therapy plus bacil- lus coagulans tablets for 10 days. Group D received bismuth quadruple therapy plus saccharomyces boulardii sachets for 10 days. Drug adverse reactions were recorded during the treatment period, and reexamine 14C-UBT in four weeks after the treatment.Results H. pylori eradication rate of group ]3 and group D were significantly higher than group A （ P〈0.05）.The eradication rate of group C was higher than group A, but the difference were without statistically significant （P〈 0.05）. The inci- dence of adverse reactions of group 13, C and D were significantly lower than group A （ P〈0.05）. However, the eradication rate and the incidence of adverse reactions had no statistical significant a- mong group B, C and D （ P〈0.05）. Conclusion Bifid triple viable capsules and S. boulardii can ira-prove H.pylori eradication rate and reduce the incidence of adverse reactions.Bacillus coagulans can not improve H.pylori eradication rates,but it can reduce the incidence of adverse reactions effectively.