益生菌治疗幽门螺杆菌阳性胃溃疡的效果及对肠道菌群分布、血清炎症因子的影响

Efficacy of probiotics in the treatment of Helicobacter pylori positive gastric ulcer and its effect on intestinal flora distribution and serum inflammatory factors

目的探讨益生菌治疗幽门螺杆菌(Hp)阳性胃溃疡患者中的效果及对肠道菌群分布、血清炎症因子的影响。方法选取2016年5月—2019年10月新乡医学院第一附属医院收治的Hp阳性胃溃疡患者170例,根据随机数字表法将患者分为观察组(85例)和对照组(85例)。对照组给予四联疗法,观察组在对照组的基础上加用双歧杆菌乳杆菌三联活菌片。比较两组临床疗效、Hp根除率、治疗前后肠道菌群分布及血清C反应蛋白(CRP)、降钙素原(PCT)及血清淀粉样蛋白A(SAA)水平变化及不良反应发生率。结果观察组的临床总有效率高于对照组(P<0.05)。观察组的Hp根除率高于对照组(P<0.05);治疗完成后4周观察组肠道双歧杆菌、乳杆菌菌群数量高于对照组,差异有统计学意义(P<0.05)。治疗完成后4周两组血清CRP、SAA均较治疗前降低,且观察组低于对照组(P<0.05);两组PCT比较,差异无统计学意义(P>0.05)。两组不良反应比较,差异无统计学意义(P>0.05)。结论益生菌联合四联疗法能提高Hp阳性胃溃疡患者的疗效,其机制可能与调节肠道菌群,减轻炎症反应有关。

Objective To explore the effect of probiotics on the distribution of intestinal flora and serum inflammatory factors in patients with Helicobacter pylori(Hp)positive gastric ulcer.Methods A total of 170 patients with Hp positive gastric ulcer admitted to the First Affiliated Hospital of Xinxiang Medical College from May 2016 to October 2019 were selected and divided into observation group(85 cases)and control group(85 cases)according to the random number table method.The control group was given quadruple therapy,and the observation group was treated with Bifidobacterium and Lactobacillus triple live bacteria tablets on the basis of the control group.The clinical efficacy,Hp eradication rate,intestinal flora distribution,serum C-reactive protein(CRP),procalcitonin(PCT)and serum amyloid A(SAA)levels before and after treatment and the incidence of adverse reactions were compared between the two groups.Results The clinical effective rate of the observation group was significantly higher than that of the control group(P<0.05).The eradication rate of Hp in the observation group was significantly higher than that in the control group(P<0.05).Four weeks after completion of treatment,the intestinal Bifidobacterium and Lactobacillus in the observation group were significantly higher than those in the control group(P<0.05).Four weeks after completion of treatment,the levels of serum CRP and SAA in the two groups were lower than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the serum PCT of the two groups(P>0.05).There was no significant difference in incidence of adverse reaction between two groups(P>0.05).Conclusion Probiotics combined with quadruple therapy can improve the curative effect of Hp positive gastric ulcer patients,and its mechanism may be related to the regulation of intestinal flora and reduction of inflammatory reaction.