益生菌用于幽门螺杆菌感染治疗的研究进展

Advances in probiotics for the treatment of helicobacter pylori infection

幽门螺杆菌被公认为在十二指肠溃疡、胃溃疡、胃腺癌等许多重要疾病中起致因作用,但是幽门螺杆菌治疗方案的根除率下降和不良反应不容忽视。而益生菌作为一种辅助治疗幽门螺杆菌感染的药物越来越受到人们的关注。幽门螺杆菌治疗方案添加益生菌可使根治率较显著提高,甚至达到80%以上,乳酸杆菌和双歧杆菌更为推荐,益生菌在服用抗生素后半小时至两小时服用。现有的资料表明鼠李糖杆菌,双歧杆菌,布拉酵母菌可做为佐剂降低不良反应的发生率,尤其是腹泻、恶心、味觉异常的发生率。部分益生菌治疗能够提高儿童根除率和降低幽门螺杆菌治疗相关的副作用。对于健康人群,益生菌的安全性较高,但是对于免疫异常、病危、肠外营养支持患者应谨慎使用。

Helicobacter pylori has been recognized as a causative agent in many important diseases, such as duodenal ulcer, gastric ulcer, gastric adenocarcinoma, etc, but the eradication rate of H. pylori treatment regimens has decreased and adverse reactions should not be ignored. However, probiotics have attracted more and more attention as an adjuvant therapy for H. pylori infection. The addition of probiotics to H. pylori treatment regimens can significantly improve the eradication rate, even reaching more than 80%. Lactobacillus and Bifidobacterium are more recommended. Probiotics should be given half an hour to two hours after taking antibiotics. Existing data indicate that Rhamnobacter rhamnosus, Bifidobacterium and Saccharomyces brasiliensis can be used as adjuvants to reduce the incidence of adverse reactions, especially diarrhea, nausea and taste disorders. Some probiotic treatments are able to improve eradication rates and reduce side effects associated with H. pylori treatment in children. Probiotics have a high safety profile in the healthy population, but should be used with caution in immunocompromised, critically ill patients, and parenteral nutrition support.