微生态制剂辅助标准四联疗法治疗Hp阳性胃溃疡的效果及对血清学指标、黏膜愈合质量的影响

Effect of microbial ecological agent assisted standard quadruple therapy on Hp positive gastric ulcer and its influences on serological indexes and mucosal healing quality

目的分析微生态制剂辅助标准四联疗法治疗幽门螺杆菌(Hp)阳性胃溃疡的效果及对血清学指标、黏膜愈合质量的影响。方法选择2020年1月至2021年4月收治的130例Hp阳性胃溃疡患者为研究对象,随机将其分为对照组和观察组,各65例。对照组采用标准四联疗法(质子泵抑制剂+2种抗生素+铋剂)治疗,观察组在标准四联疗法基础上给予微生态制剂(双歧杆菌乳杆菌三联活菌片)治疗。比较两组的临床疗效、Hp转阴率、炎症因子、胃肠激素水平及黏膜愈合质量。结果观察组的治疗总有效率和Hp转阴率高于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)及基质金属蛋白酶-9(MMP-9)水平比较,差异无统计学意义(P>0.05);治疗后,两组的IL-6、IL-8、TNF-α及MMP-9水平均较治疗前降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的胃泌素(GAS)、胃动素(MTL)、胃蛋白酶原Ⅰ(PGⅠ)及胃蛋白酶原Ⅱ(PGⅡ)水平比较,差异无统计学意义(P>0.05);治疗后,两组的GAS、MTL、PGⅠ及PGⅡ水平均较治疗前降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的胶原纤维沉积面积、Ⅰ型/Ⅲ型胶原蛋白比值及羟脯氨酸水平比较,差异无统计学意义(P>0.05);治疗后,观察组的胶原纤维沉积面积、Ⅰ型/Ⅲ型胶原蛋白比值及羟脯氨酸水平高于对照组,差异具有统计学意义(P<0.05)。结论微生态制剂辅助标准四联疗法治疗Hp阳性胃溃疡的效果显著,可提高Hp转阴率,减轻炎症反应,改善胃肠激素水平,提升黏膜愈合质量,值得临床应用。

Objective To analyze the effect of microbial ecological agent assisted standard quadruple therapy on Helicobacter pylori(Hp)positive gastric ulcer and its influences on serological indexes and mucosal healing quality.Methods A total of 130 patients with Hp positive gastric ulcer admitted from January 2020 to April 2021 were selected as the research subjects and randomly divided into control group and observation group,with 65 cases in each group.The control group was treated with standard quadruple therapy(proton pump inhibitor+2 antibiotics+bismuth),and the observation group was treated with microbial ecological agent(live combined Bifidobacterium and Lactobacillus tablets)on the basis of standard quadruple therapy.The clinical efficacy,Hp negative conversion rate,inflammatory factors,gastrointestinal hormones levels and mucosal healing quality were compared between the two groups.Results The total effective rate of treatment and Hp negative conversion rate of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and matrix metalloproteinase-9(MMP-9)between the two groups(P>0.05);after treatment,the levels of IL-6,IL-8,TNF-αand MMP-9 in the two groups were lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of gastrin(GAS),motilin(MTL),pepsinogenⅠ(PGⅠ)and pepsinogenⅡ(PGⅡ)between the two groups(P>0.05);after treatment,the levels of GAS,MTL,PGⅠand PGⅡin the two groups were lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in collagen fiber deposition area,typeⅠ/Ⅲcollagen ratio and hydroxyproline level between the two groups(P>0.05);after treatment,the collagen fiber deposition area,typeⅠ/Ⅲcollagen ratio and hydroxyproline level in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Microbial ecological agent assisted standard quadruple therapy in the treatment of Hp positive gastric ulcer has a significant effect,it can improve Hp negative conversion rate,reduce inflammatory reaction,improve gastrointestinal hormones levels,and promote mucosal healing quality,which is worthy of clinical application.