双歧杆菌三联活菌联合三联疗法治疗幽门螺杆菌感染性胃溃疡疗效观察

Observation on the Clinical Efficacy of Bifid Triple Viable Combined with Triple Therapy in the Treatment of H.pylori Infected Gastric Ulcer

目的探讨双歧杆菌三联活菌联合常规三联疗法治疗幽门螺杆菌(helicobacter pylori,Hp)感染性胃溃疡的临床疗效方法选取2016年2月至2018年4月南阳市第二人民医院消化内科收治的90例Hp感染性胃溃疡患者作为研究对象,并按照随机数表法将其随机分为试验组与对照组,每组45例,其中对照组患者行奥美拉唑+甲硝唑+阿莫西林三联疗法治疗,试验组患者在奥美拉唑+甲硝唑+阿莫西林三联疗法治疗的基础上加用双歧杆菌三联活菌治疗,对比观察两组患者的临床疗效和胃液pH值、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、降钙素原(PCT)的变化情况,以及Hp转阴率和腹胀、恶心、呕吐、头晕等不良反应的发生情况结果治疗2周后,试验组患者治疗总有效率为95.56%,明高于对照组患者的治疗总有效率82.22%,差异具有统计学意义(Mann-Whitney U=813.500,Z=-2.018,P=0.044);试验组患者胃液pH值明显高于对照组,而TNF-α、IL-8、PCT水平明显低于对照组,差异具有统计学意义(t=9.952、2.876、8.603、6.891,P=0.000、0.005、0.000、0.000);试验组患者Hp转阴率为82.22%,明显高于对照组患者的Hp转阴率37.78%,差异具有统计学意义(χ^2=18.519,P=0.000)。治疗过程中,试验组患者不良反应发生率为8.89%,对照组患者不良反应发生率为13.33%,差异无统计学意义(χ^2=0.450,P=0.502)结论Hp感染性胃溃疡患者在常规三联疗法治疗的基础上联合应用双歧杆菌三联活菌,能够有效减轻患者的炎症反应,维持肠道内环境平衡,提高Hp转阴率,效果显著,临床应用价值较高。

Objective To investigate the clinical efficacy of bifid triple viable combined with conventional triple therapy in the treatment of H.pylori(Hp)infected gastric ulcer.Methods Ninety patients with H.pylori infected gastric ulcer,admitted to the Department of Gastroenterology and Hepatology,Nanyang Second General Hospital from February2016 to April 2018,were selected as subjects and then divided,according to random number table,into an experiment group(45 cases)and a control group(45 cases).Patients in the control group were treated with triple therapy consisting of omeprazole+metronidazole+amoxicillin.In addition to the above triple therapy,patients in the experiment group also treated with bifid triple viable.The clinical efficacy and changes of pH value of gastric juice,tumor necrosis factorα(TNF-α),interleukin 8(IL-8),and procalcitonin(PCT),as well as Hp negative conversion rate and adverse reactions such as abdominal distension,vomit,dizziness were compared and analyzed.Results After 2 weeks of treatment,the total effective rate in the experiment group was 95.56%,which was significantly higher than 82.22%in the control group and the results of comparison showed statistically significant difference(Mann-Whitney U=813.500,Z=-2.018,P=0.044);the pH value of gastric juice in the experiment group was significantly higher than that in the control group,while the levels of TNF-α,IL-8,and PCT in the experiment group were significantly lower than those in the control group,and the results of comparison showed statistically significant difference(t=9.952,2.876,8.603,6.891,P=0.000,0.005,0.000,0.000);the Hp negative conversion rate in the experiment group was 82.22%,much higher than 37.78%in the control group and the results of comparison showed statistically significant difference(χ^2=18.519,P=0.000).During treatment,the incidence of adverse reactions was 8.89%in the experiment group and 13.33%in the control group and the results of comparison showed no statistically significant difference(χ^2=0.450,P=0.502).Conclusion Conventional triple therapy combined with bifid triple viable in the treatment of patients with Hp infected gastric ulcer can reduce inflammatory response,maintain the balance of intestinal environment,and increase Hp negative conversion rate.Such therapy has good treatment effect and high clinical value.