乳酸菌素片联合标准四联疗法对社区消化性溃疡患者胃电图及肠道菌群的影响

Effects of Lactobacillin Tablets combined with standard quadruple therapy on electrogastrogram and intestinal flora in patients with peptic ulcer in community

目的探讨乳酸菌素片结合标准四联疗法对社区消化性溃疡(PU)患者胃电图及肠道菌群的影响,为该类患者的治疗提供参考。方法选取2018年1月至2020年3月社区PU患者128例,随机分为对照组和试验组,各64例。对照组患者给予标准四联疗法,试验组在对照组基础上给予乳酸菌素片,两组患者均治疗14 d。观察两组患者H.pylori根除率、治疗效果、再生黏膜组织学成熟度、不良反应及治疗前后胃电图(胃肠电节律紊乱、平均频率)、胃肠激素[胃蛋白原Ⅰ(PGⅠ)、生长抑素(SS)、生长激素释放多肽(Ghrelin)]、肠道菌群(革兰阳性球菌、革兰阴性球菌、革兰阳性杆菌)水平,并于治疗后3个月随访PU复发率。结果试验组患者治疗总有效率(95.31%)、H.pylori根除率(87.50%)及再生黏膜组织学成熟度均高于对照组(均P<0.05)。胃电图检测显示,治疗后试验组患者餐前、餐后平均频率及胃肠电节律紊乱均低于对照组(均P<0.05)。治疗后试验组患者血清SS水平高于对照组,PGⅠ、Ghrelin水平低于对照组(均P<0.05)。治疗后试验组患者肠道革兰阴性球菌数量高于对照组,革兰阳性杆菌数量低于对照组(均P<0.05)。两组患者不良反应发生率及PU复发率比较差异无统计学意义(均P>0.05)。结论乳酸菌素片结合标准四联疗法治疗社区PU患者的疗效确切,可有效调控患者胃肠激素,提高H.pylori根除率,安全性较高。

Objective To observe the effects of Lactobacillin Tablets combined with standard quadruple therapy on electrogastrogram and intestinal flora of patients with peptic ulcer(PU) in the community and provide a reference for the treatment. Methods A total of 128 patients with PU in the community from January 2018 to Mar 2019 were divided into Observation group or Test group randomly, with 64 cases in each group. Both groups were given standard quadruple therapy, while the observation group was additionally given Lactobacillin Tablets, for 14 days. The H. pylori eradication rate, efficacy, histological maturity of regenerative mucosa, adverse reactions, electrogastrogram(gastrointestinal electrical rhythm disorder, average frequency), gastrointestinal hormones [progestin I(PG I), somatostatin(SS), growth hormone releasing polypeptide(Ghrelin)], intestinal flora(Gram positive cocci, Gram negative cocci, Gram positive bacilli) before and after treatment in the two groups were observed, and the PU recurrence rate was followed up 3 months after treatment. Results The total efficiency rate(95.31%) and H. pylori eradication rate(87.50%) in the observation group were higher than those in the Test group respectively(all P<0.05). The histological maturity of regenerative mucosa, the average frequency and gastrointestinal electrical rhythm disorders before and after meals in the observation group were better than those in the Test group respectively(all P<0.05). Serum SS levels in the observation group were higher, and those of PG I and Ghrelin were lower than in the Test group respectively after treatment(all P<0.05). After treatment, the amount of intestinal Gram negative cocci in the observation group was higher, while that of the positive bacilli were lower than in the Test group respectively(all P<0.05). There were no significant differences in the incidence of adverse reactions and PU recurrence between the two groups(all P>0.05). Conclusion Lactobacillin Tablets combined with standard quadruple therapy is effective in treating community PU, which can regulate gastrointestinal hormones, improve H. pylori eradication rate and have higher safety.