含米诺环素和奥硝唑的四联疗法联合双歧杆菌乳杆菌三联活菌片根除幽门螺杆菌的效果

The efficacy of quadruple therapy containing Minocycline and Ornidazole combined with Bifidobacterium Lactobacillus Trifecta in the eradication of Helicobacter pylori

目的研究含米诺环素及奥硝唑的四联疗法的有效性和安全性,并分析双歧杆菌乳杆菌三联活菌片(金双歧)在幽门螺杆菌根除治疗中的效果,指导临床实践。方法回顾性分析2018年5月至2019年5月福建省立医院收治的101例幽门螺杆菌阳性患者,所有患者均采用艾司奥美拉唑+米诺环素+奥硝唑+铋剂四联方案,其中51例患者联合金双歧治疗,比较各类患者治疗效果及不良反应。通过13C尿素呼气试验评估幽门螺杆菌根除情况。不良反应及临床症状缓解情况通过访谈进行评估。结果 101例患者幽门螺杆菌总根除率为94.06%(95%CI:87.01%~97.56%),共出现不良反应19例,不良反应率为18.81%(95%CI:11.98%~28.07%)。90.10%的患者依从性良好。联合和不联合金双歧的患者其幽门螺杆菌根除率差异无统计学意义(92.2%vs 96.0%,P=0.678 0),临床症状缓解情况差异也无统计学意义(P=0.444 0),但联合金双歧可减少治疗不良反应发生率(P=0.005 0)。结论含米诺环素和奥硝唑的四联疗法是根除幽门螺杆菌有效且耐受性良好的方案。补充金双歧不能提高患者根除率,但可以减少治疗时的不良反应。

Objective To study the efficacy and safety of a quadruple therapy containing Minocycline and Ornidazole, and observe the effect of Bifidobacterium Lactobacillus Trifecta(Gold Bifidum) in the eradication of Helicobacter pylori, so as to guide the clinical practice. Methods A retrospective study was conducted in 101 patients with positive Helicobacter pylori in Fujian Provincial Hospital from May 2018 to May 2019. All the patients were treated with quadruple regimen of Esomeprazole + Minocycline + Ornidazole + Bismuth. Among them, 51 patients(observation group) were additionally given Bifidobacterium Lactobacillus Trifecta therapy. The therapeutic effect and adverse reactions were compared between groups. The eradication of Helicobacter pylori was assessed by 13C-urea breath test. Adverse reactions and remission of clinical symptoms were evaluated through follow-up. Results The total eradication rate was 94.06%(95% CI: 87.01%-97.56%). A total of 19 cases(18.81%) of adverse reactions were observed(95% CI: 11.98%-28.07%). 90.10% of patients had high compliance. There was no difference in the Helicobacter pylori eradication rate(92.2% vs 96.0%, P=0.678) and no difference in the remission of clinical symptoms(P=0.444) between groups, but the incidence of adverse reactions was reduced in the observation group(P=0.005). Conclusion The quadruple therapy containing Minocycline and Ornidazole is an effective and well-tolerated regimen for the eradication of Helicobacter pylori. Supplementation of Bifidobacterium Lactobacillus Trifecta can not improve the eradication rate, but reduce the adverse reactions in the treatment.