枯草杆菌联合四联疗法补救对老年幽门螺杆菌感染者的疗效

Curative efficacy of Bacillus subtilis combined with quadruple therapy in treatment of Helicobacter pylori infection in the elderly

目的探讨枯草杆菌联合四联疗法补救对老年幽门螺杆菌(Hp)感染者的疗效。方法选择2014年2月至2016年2月都江堰市医疗中心消化内科收治的Hp感染治疗失败需要接受补救治疗的老年患者100例,随机分为观察组50例,对照组50例。对照组使用含阿莫西林、呋喃唑酮、兰索拉唑和胶体果胶铋四联疗法治疗,观察组在此基础上联合枯草杆菌进行治疗。比较两组患者的血清超氧化物歧化酶(SOD)、丙二醛(MDA)和一氧化氮(NO)表达水平,以及两组治疗后的Hp转阴率、不良反应发生情况。结果治疗后,观察组Hp转阴率显著高于对照组,差异有统计学意义(P<0.05);两组患者治疗前血清SOD、MDA及NO水平差异无统计学意义(P>0.05);治疗后,两组患者血清SOD、NO水平均明显上升,MDA水平明显下降,且观察组SOD、NO水平显著高于对照组,MDA水平明显低于对照组,差异均有统计学意义(P均<0.05);两组患者的不良反应发生率差异无统计学意义(P>0.05)。结论枯草杆菌联合四联疗法补救对老年Hp感染者的疗效较好,不良反应较少,患者可以耐受,值得推广应用。

Objective This paper is to study curative efficacy of Bacillus subtilis combined with quadruple therapy in treatment of Helicobacter pylori （Hp） infection in the elderly.Methods One hundred cases of elderly patients who needed remedial treatment for failed Hp infection treatment in the Department of Digestive Medicine in Dujiangyan Medical Center, from February 2014 to February 2016 were selected, of which, fifty cases were randomly assigned to the observation group and fifty cases in the control group. The control group was treated with amoxicillin, furazolidone, lansoprazole, and colloidal bismuth pectin, while the observation group was further treated with Bacillus subtilis apart from the treatment of the control group. The clinical efficacy and serum superoxide dismutase （SOD）, malondialdehyde （MDA）, NO levels, and the conversion rate of Hp infection of the two groups after treatment were compared. The adverse reactions of the two groups were recorded.Results After treatment, the conversion rate of Hp in the observation group was higher than that in the control group （P〈0.05）. There was no significant difference in serum SOD, MDA, and NO levels between the two groups before treatment （P〉0.05）. After treatment, serum SOD and NO levels of both groups increased significantly, and MDA levels decreased significantly. SOD and NO levels of the observation group were significantly higher than those of the control group, and MDA levels were significantly lower than those of the control group （P〈0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups （P〉0.05）.Conclusion Bacillus subtilis combined with quadruple therapy has a higher curative effect and less adverse reaction on elderly patients with gastric Hp infection.