益生菌对幽门螺杆菌根除后肠道微生物群分布的影响

Effects of probiotics on the distribution of intestinal microbiota after eradication of Helicobacter pylori

目的检验益生菌对幽门螺杆菌根除后肠道微生物群分布的影响。方法病人分为三联疗法根除组(A组)和三联疗法根除+双歧杆菌三联活菌胶囊联用组(B组)。治疗14天后对病人治疗效果进行多方面评估。收集治疗后患者的粪便样本进行qPCR分析,检测大肠埃希菌、肠球菌、肺炎克雷伯菌、乳杆菌、双歧杆菌及嗜热链球菌的数量。结果120例患者中有112例按方案完成治疗,完成率为93.3%。A组患者中失访2例,不耐受5例,治疗完成率为88.3%;B组患者中失访3例,不耐受4例,治疗完成率为88.3%。双歧杆菌三联活菌胶囊降低了患者的不良反应并提高了三联疗法根除的治愈率。A组大肠杆菌及肺炎克雷伯菌相对表达水平明显高于B组;然而B组粪肠球菌、双歧杆菌、乳酸杆菌及嗜热链球菌表达高于A组。结论益生菌的使用对提高三联疗法根除幽门螺杆菌有促进作用。

Objective To explore the effect of probiotics on the distribution of intestinal microbiota after Helicobacter pylori eradication.Methods The patients were divided into group A（triple therapy eradication）or group B（triple therapy eradication combined with triple viable Bifidobacterium-Lactobacillus capsules）respectively.After 14 days of treatment,the therapeutic effect was evaluated,and the fecal samples of patients were collected for qPCR analysis to detect the amounts of E.coli,Enterococci,Klebsiella pneumoniae,Lactobacilli,Bifidobacteria and Streptococcus thermophilus.Results Of the 120 patients,112（93.3%）completed the treatment according to the protocol.In group A,2 patients were lost to follow-up and 5 patients did not tolerate;the completion rate of treatment was 88.3%.In group B,3 patients were lost to follow-up and 4 patients did not tolerate;the completion rate of treatment was 88.3%.Triple viable Bifidobacterium-Lactobacillus capsules reduced adverse reactions and improved the cure rate of triple therapy eradication.The relative expression levels of E.coli and K.pneumoniae in group A were significantly higher than those in group B,while E.coli,Bifidobacteria,Lactobacilli and Streptococcus thermophilus were more highly expressed in group B than in group A.Conclusion Probiotics promotes the eradication of Helicobacter pylori by triple therapy.