不同干预时机下复方嗜酸乳杆菌片联合四联疗法在根除幽门螺杆菌失败补救治疗中的应用

Effect of Compound Lactobacillus acidophilus tablets at different intervention timing combined with quadruple therapy in patients with failed first eradication of Helicobacter pylori

目的探讨不同干预时机下复方嗜酸乳杆菌片联合四联疗法在首次根除幽门螺杆菌(H.pylori)失败患者补救治疗中的作用。方法选择西安市第一医院消化内科90例经标准四联疗法根除H.pylori失败的患者为研究对象,随机分为研究组A(A组)、研究组B(B组)与对照组(C组),各30例。A组患者使用复方嗜酸乳杆菌片联合补救四联疗法治疗。B组患者在补救四联疗法结束后序贯使用复方嗜酸乳杆菌片2周。C组患者单独采用补救四联疗法治疗。比较3组患者临床症状、不良反应发生率及H.pylori根除率。结果A组、B组、C组患者总有效率分别为93.33%(28/30),90.00%(27/30),66.67%(20/30),差异有统计学意义(χ^(2)=9.120,P=0.010)。A组、B组、C组患者总不良反应发生率分别为13.33%(4/30)、16.67%(5/30)、66.67%(20/30),差异有统计学意义(χ^(2)=24.522,P<0.001)。A组、B组、C组患者H.pylori根除率分别为60.00%(18/30)、63.33%(19/30)、33.33%(10/30),差异有统计学意义(χ^(2)=6.502,P=0.039)。A组与B组患者H.pylori根除率相比差异无统计学意义(χ^(2)=0.071,P=0.791)。结论复方嗜酸乳杆菌片联合四联疗法可提高首次四联疗法根除H.pylori失败患者H.pylori根除率,改善患者临床症状,降低总体不良反应发生率,但不同干预时机下复方嗜酸乳杆菌片对H.pylori根除率无明显影响。

Objective To observe the effect of compound Lactobacillus acidophilus tablets at different intervention timing combined with quadruple therapy in patients with failed first eradication of H.pylori.Methods A total of 90 H.pylori infection patients who failed to have H.pylori eradicated with standard quadruple therapy were enrolled and divided into observation group A(group A),observation group B(group B)or control group(group C),30cases in each group.The group A was given compound Lactobacillus acidophilus tablets combined with remedial quadruple therapy.Group B was given compound Lactobacillus acidophilus tablets for 2weeks after the end of remedial quadruple therapy.Group C was given remedial quadruple therapy alone.Clinical symptoms,incidences of adverse reactions and eradication rate of H.pylori were compared among the three groups.Results The improvement rates of clinical symptoms in groups A,B and C were 93.33%(28/30),90.00%(27/30)and 66.67%(20/30),respectively,with statistically significant difference(χ^(2)=9.120,P=0.010).The incidences of overall adverse reactions in group A,B and C were 13.33%(4/30),16.67%(5/30),66.67%(20/30),respectively,with statistically significant difference(χ^(2)=24.522,P<0.001).The eradication rates of H.pyloriin groups A,B and C were 60.00%(18/30),63.33%(19/30)and 33.33%(10/30),respectively,with statistically significant differences(χ^(2)=6.502,P=0.039).There was no significant difference in H.pylori eradication rate between group A and group B(χ^(2)=0.071,P=0.791).Conclusion Compound Lactobacillus acidophilus tablets combined with quadruple therapy can improve H.pylori eradication rate in patients with failed first eradication of H.pylori,improve clinical symptoms,and reduce the overall incidence of adverse reactions.However,different intervention timing of compound Lactobacillus acidophilus tablets has no obvious effect on H.pylori eradication rate.