益生菌辅助基于艾司奥美拉唑的四联方案治疗Hp阳性胃溃疡的疗效及对肠道菌群的影响分析

Efficacy of Probiotic-Assisted Estramiprazole-Based Quadruple Regimen in the Treatment of Hp-Positive Gastric Ulcer and Analysis of the Effect on Intestinal Flora

目的:探讨益生菌辅助基于艾司奥美拉唑的四联方案治疗幽门螺杆菌(H.pylori,Hp)阳性胃溃疡的疗效及对肠道菌群的影响。方法:选择我院2019年5月至2021年5月收治的123例Hp阳性胃溃疡患者进行研究,使用随机数字表,采用简单随机的方法将其分为研究组63例,对照组60例,给予对照组基于艾司奥美拉唑的四联方案治疗,研究组在此基础上,给予益生菌(布拉氏酵母菌)治疗,两组均治疗14d,比较两组Hp根除率、溃疡面愈合情况、肠道菌群及不良反应。结果:研究组溃疡面愈合率与Hp根除率均高于对照组,差异有统计学意义(P<0.05),对照组治疗后产气荚膜梭菌、双歧杆菌、乳杆菌水平低于治疗前(P<0.05),肠杆菌、酵母菌、肠球菌水平高于治疗前(P<0.05),B/E值低于治疗前(P<0.05);研究组治疗后双歧杆菌、乳杆菌水平高于治疗前(P<0.05),产气荚膜梭菌水平低于治疗前(P<0.05),肠杆菌、肠球菌、酵母菌水平与治疗前无显著差异(P>0.05),研究组治疗后B/E值高于对照组(P<0.05)。结论:益生菌辅助基于艾司奥美拉唑的四联方案治疗幽门螺杆菌Hp阳性胃溃疡患者能显著提高清除率,促进溃疡面的愈合,对促进肠道菌群环境平衡具有积极的作用,适合推广。

Objective:To investigate the efficacy of a probiotic-assisted quadruple regimen based on esomeprazole in the treatment of Helicobacter pylori(H.pylori,Hp)positive gastric ulcer and its effect on the intestinal flora.Methods:A total of 123 patients with Hp-positive gastric ulcers who were admitted to our hospital from May 2019 to May 2021 were selected for research,and they were divided into a study group(N=63)and a control group(N=60)by a simple random method using a random number table.The group was treated with a quadruple regimen based on esomeprazole,and the research group was given probiotics(Saccharomyces boulardii)on this basis.Both groups were treated for 14 days,and the Hp eradication rate,ulcer surface healing,intestinal flora,and adverse effects between the two groups were compared.Results:The rate of ulcer surface healing and Hp eradication were higher in the study group than in the control group,with statistically significant differences(P<0.05).The levels of Clostridium perfringens,Bifidobacterium,and Lactobacillus were lower in the control group than before treatment(P<0.05),while the levels of Enterobacter,Yeast,and Enterococcus were higher(P<0.05)and the B/E values were lower(P<0.05).The levels of Bifidobacterium and Lactobacillus in the study group were higher than before treatment(P<0.05),the levels of Clostridium perfringens were lower than before treatment(P<0.05),and the levels of Enterobacter,Enterococcus and Yeast were not significantly different from before treatment(P>0.05).Conclusion:The probiotic-assisted estramiprazole-based quadruple regimen for the treatment of patients with H.pylori Hp-positive gastric ulcers significantly improves clearance rates,promotes healing of the ulcer surface,and has a positive effect on promoting a balanced intestinal flora environment,making it suitable for promotion.