双歧杆菌与胶体果胶铋联合三联疗法根除幽门螺杆菌的临床研究

The therapy in the eradication of helicobacter pylori by bifidobacterium and bismuth combined with standard triple therapy

[目的]评估双歧杆菌与胶体果胶铋联合三联疗法根除Hp方案的根除率和治疗相关不良事件率的影响。[方法]选取我院2016年8月~2018年8月确诊的Hp感染患者共320例(失访10例)进入研究队列,随机分成4组:A组采用三联疗法、B组采用胶体果胶铋联合三联疗法、C组采用双歧杆菌(2周)联合三联疗法、D组采用双歧杆菌(4周)联合三联疗法。比较各组中Hp根除率和治疗相关不良事件率的关系。[结果]与三联疗法比较,联合胶体果胶铋或双歧杆菌(2周、4周)均有较高的Hp根除率(χ2=6.05、7.81、4.59,P<0.01),且不良事件发生率更低(χ2=4.27、13.09、15.24,P<0.05)。与胶体果胶铋比较,双歧杆菌联合三联疗法的Hp的根除率差异无统计学意义(χ2=0.31、0.25,P>0.05),但不良事件发生率更低(χ2=4.02、4.02,P<0.05)。而使用双歧杆菌的时间长短对Hp根除率(χ2=1.11,P>0.05)和治疗相关不良事件率(χ2=0.00,P>0.05),差异无统计学意义。[结论]与传统三联疗法比较,联合双歧杆菌或胶体果胶铋的四联方案治疗Hp感染根除率更高,同时双歧杆菌联合三联方案相比胶体果胶铋方案有更低的不良事件发生率。

[Objective]To investigate the effects of bifidobacteria and bismuth combined with triple therapy on the eradication rate and the rate of treatment-related adverse events in the Hp regimen.[Methods]A randomized controlled trial was performed between 320 patients who were diagnosed with Hp infection from 2016.8 to 2018.8 in our hospital(10 patients lost in follow-up)were enrolled in the study and randomly divided into four groups:group A with triple therapy,group B with bismuth and triple therapy,group C with bifidobacteria.(2 weeks)combined with triple therapy,group D with bifidobacteria(2 weeks)combined with triple therapy.The relationship between Hp eradication rate and treatment-related adverse event rates in each group was compared.[Results]Compared with triple therapy,the addition of bismuth or bifidobacteria(2 weeks,4 weeks)had better Hp eradication rate(χ2=6.05,7.81,4.59,P<0.01),and the incidence of adverse events was lower(χ2=4.27,13.09,15.24,P<0.05).Compared with bismuth,the eradication rate of Bifidobacterium combined with triple therapy showed no statistical difference(χ2=0.31,0.25,P>0.05),but the incidence of adverse events was lower(χ2=4.02,4.02,P<0.05).The length of time using Bifidobacteria had no statistically different in Hp eradication rate(χ2=1.11,P>0.05)and treatment-related adverse event rate(χ2=0.00,P >0.05).[Conclusion]Compared with traditional triple therapy,the quadruple regimen of Bifidobacterium or bismuth is more effective in eradicating Hp infection,and the Bifidobacterium combined triple therapy has lower adverse events than the bismuth regimen rate.