BACKGROUND Helicobacter pylori(H.pylori)is the main pathogen that causes a variety of upper digestive diseases.The drug resistance rate of H.pylori is increasingly higher,and the eradication rate is increasingly lower...BACKGROUND Helicobacter pylori(H.pylori)is the main pathogen that causes a variety of upper digestive diseases.The drug resistance rate of H.pylori is increasingly higher,and the eradication rate is increasingly lower.The antimicrobial resistance of H.pylori is an urgent global problem.It has been confirmed that Banxia Xiexin decoction(BXXXT)demonstrates the effects of treating gastrointestinal diseases,inhibiting H.pylori and protecting gastric mucosa.The purpose of the present study is to further explore the therapeutic effects of BXXXT on drug-resistant H.pylori.AIM To confirm that BXXXT demonstrates therapeutical effects in vivo and in vitro on gastritis mice with drug-resistant H.pylori and explain its mechanism to provide an experimental basis for promoting the application of BXXXT.METHODS The aqueous extract of BXXXT was gained by water decocting method.The inhibitory effect of the aqueous extract on H.pylori was detected by dilution in vitro;drug-resistant H.pylori cells were used to build an acute gastritis model in vivo.Thereafter,the model mice were treated with the aqueous extract of BXXXT.The amount of H.pylori colonization,the repair of gastric mucosal damage,changes of inflammatory factors,apoptosis,etc.,were assessed.In terms of mechanism exploration,the main medicinal compositions of BXXXT aqueous extract and the synergistic bacteriostatic effects they had demonstrated were analyzed using mass spectrometry;the immune function of peripheral blood cells such as CD3+T and CD4+T of mice with gastritis before and after treatment with BXXXT aqueous extract was detected using a flow cytometry;the H.pylori transcriptome and proteome after treatment with BXXXT aqueous extract were detected.Differently expressed genes were screened and verification was performed thereon with knockout expression.RESULTS The minimum inhibitory concentration of BXXXT aqueous extract against H.pylori was 256-512μg/mL.A dose of 28 mg/kg BXXXT aqueous extract treatment produced better therapeutical effects than the standard triple therapy did;the BXXXT aqueous extract have at least 11 ingredients inhibiting H.pylori,including berberine,quercetin,baicalin,luteolin,gallic acid,rosmarinic acid,aloe emodin,etc.,of which berberine,aloe emodin,luteolin and gallic acid have a synergistic effect;BXXXT aqueous extract was found to stimulate the expressions of CD3+T and CD4+T and increase the number of CD4+T/CD8+T in gastritis mice;the detection of transcriptome and proteome,quantitative polymerase chain reaction,Western blotting and knockout verification revealed that the main targets of BXXXT aqueous extract are CFAs related to urea enzymes,and CagA,VacA,etc.CONCLUSION BXXXT aqueous extract could demonstrate good therapeutic effects on drug-resistance H.pylori in vitro and in vivo and its mechanism comes down to the synergistic or additional antibacterial effects of berberine,emodin and luteolin,the main components of the extract;the extract could activate the immune function and enhance bactericidal effects;BXXXT aqueous extract,with main targets of BXXXT aqueous extract related to urease,virulence factors,etc.,could reduce the urease and virulence of H.pylori,weaken its colonization,and reduce its inflammatory damage to the gastric mucosa.展开更多
AIM： To evaluate whether adding azithromycin to firstline Helicobacter pylori （H pylorl） eradication improved eradication and reduced side effects. METHODS： Eligible articles were identified by searches of electro...AIM： To evaluate whether adding azithromycin to firstline Helicobacter pylori （H pylorl） eradication improved eradication and reduced side effects. METHODS： Eligible articles were identified by searches of electronic databases. We included all randomized trials that compared azithromycin-containing with standard triple-therapy regimens for first-line treatment of H pylori infection. Statistical analysis was performed with Review Manager 5.0.10. Sub-analyses were also performed. RESULTS： We identified 14 randomized trials （1431 patients）. Pooled Hpylori eradication rates were 72.01% （95% CI： 58.09%-85.93%） and 69.78% （95% CI： 66.47%-73.09%） for patients with or without azithromycin by intention-to-treat analysis, and the odds ratio （OR） was 1.17 （95% CI： 0.64-2.14）. The occurrence of side effects differed significantly and was 15.81% （95% CI： 12.50%-19.12%） and 25.20% （95% CI： 21.44%-28.96%） for treatment with or without azithromycin, respectively, and the summary OR was 0.58 （95% CI： 0.41-0.82）. Furthermore, the azithromycin-containing group had a lower occurrence of diarrhea, nausea and taste disturbance. CONCLUSION： Our review suggests that azithromycincontaining triple-therapy regimens could be equally effective in eradication of Hpylori compared with standard first-line triple-therapy regimens.展开更多
Aim To evaluate the efficacy and cost-effectiveness of one-week regiment of quadruple and triple therapy containing:Lansoprazle(L),colloidal bismuth subciteate(B),amoxicillin(A),metrnidozole(M) and furazolidone(F).Met...Aim To evaluate the efficacy and cost-effectiveness of one-week regiment of quadruple and triple therapy containing:Lansoprazle(L),colloidal bismuth subciteate(B),amoxicillin(A),metrnidozole(M) and furazolidone(F).Methods 227 patients with duodenal ulcer(DU) or non-ulcer dyspepsia (NUD) confirmed by endoscopy were received LAFB,LAM or LAF,twice daily for 7 days.Endoscopy was performed in DU and 14 C-UBT was performed in NUD 4 weeks after completion of treatment.Results (1)The eradication rate of H.pylori by LAFB,LAM and LAF were 96.30%,84.51% and 70.59% respectively(LAFB vs LAF and LAF,P<0.05;LAFB vs LAM P<0.01).The healing rate of DU had no difference between three regiment P<0.05).The cost-effectiveness analysis on eradication of H.pylori showed that cost/effectiveness (C/E) of LAFB is the lowest.(2)The healing rate of DU ulcer in H.pylori eradicated patients was higher than that in uneradicated ones(98.94% vs 50%,P<0.01).The rate of ulcer recurrent of year was lower in H.pylori eradicated patients than that in uneradicated patients(2.15% vs 71.42%,P<0.01).(3)The rate of relieving symptom and recurrenting symptom in one year had no difference between H.pylori eradicated patients and uneradicated patiens in NUD(71.74% vs 70% and 53.03 vs 50,P>0.05).Conclusions The efficacy of one week regiment of quadruple therapy is higher than that in triple therapy but the side effect was not higher.The higher eradication rate is caused by combination of furazolidone,bacause it is low resis tant to H.pylori.It is also a cost-saving strategy.Eradication of H.pylori infection could improve ulcer healing and decrease the rate of ulcer recurrent but is not likely to relieve symptomes in NUD patients.展开更多
基金the National Natural Science Foundation of China,No.81760739Special Fund Projects for Guide Local Science and Technology Development by the China government,No.GUIKEZY201980042022 Guangxi Graduate Education Innovation Plan Project,No.YCBZ2022071.
文摘BACKGROUND Helicobacter pylori(H.pylori)is the main pathogen that causes a variety of upper digestive diseases.The drug resistance rate of H.pylori is increasingly higher,and the eradication rate is increasingly lower.The antimicrobial resistance of H.pylori is an urgent global problem.It has been confirmed that Banxia Xiexin decoction(BXXXT)demonstrates the effects of treating gastrointestinal diseases,inhibiting H.pylori and protecting gastric mucosa.The purpose of the present study is to further explore the therapeutic effects of BXXXT on drug-resistant H.pylori.AIM To confirm that BXXXT demonstrates therapeutical effects in vivo and in vitro on gastritis mice with drug-resistant H.pylori and explain its mechanism to provide an experimental basis for promoting the application of BXXXT.METHODS The aqueous extract of BXXXT was gained by water decocting method.The inhibitory effect of the aqueous extract on H.pylori was detected by dilution in vitro;drug-resistant H.pylori cells were used to build an acute gastritis model in vivo.Thereafter,the model mice were treated with the aqueous extract of BXXXT.The amount of H.pylori colonization,the repair of gastric mucosal damage,changes of inflammatory factors,apoptosis,etc.,were assessed.In terms of mechanism exploration,the main medicinal compositions of BXXXT aqueous extract and the synergistic bacteriostatic effects they had demonstrated were analyzed using mass spectrometry;the immune function of peripheral blood cells such as CD3+T and CD4+T of mice with gastritis before and after treatment with BXXXT aqueous extract was detected using a flow cytometry;the H.pylori transcriptome and proteome after treatment with BXXXT aqueous extract were detected.Differently expressed genes were screened and verification was performed thereon with knockout expression.RESULTS The minimum inhibitory concentration of BXXXT aqueous extract against H.pylori was 256-512μg/mL.A dose of 28 mg/kg BXXXT aqueous extract treatment produced better therapeutical effects than the standard triple therapy did;the BXXXT aqueous extract have at least 11 ingredients inhibiting H.pylori,including berberine,quercetin,baicalin,luteolin,gallic acid,rosmarinic acid,aloe emodin,etc.,of which berberine,aloe emodin,luteolin and gallic acid have a synergistic effect;BXXXT aqueous extract was found to stimulate the expressions of CD3+T and CD4+T and increase the number of CD4+T/CD8+T in gastritis mice;the detection of transcriptome and proteome,quantitative polymerase chain reaction,Western blotting and knockout verification revealed that the main targets of BXXXT aqueous extract are CFAs related to urea enzymes,and CagA,VacA,etc.CONCLUSION BXXXT aqueous extract could demonstrate good therapeutic effects on drug-resistance H.pylori in vitro and in vivo and its mechanism comes down to the synergistic or additional antibacterial effects of berberine,emodin and luteolin,the main components of the extract;the extract could activate the immune function and enhance bactericidal effects;BXXXT aqueous extract,with main targets of BXXXT aqueous extract related to urease,virulence factors,etc.,could reduce the urease and virulence of H.pylori,weaken its colonization,and reduce its inflammatory damage to the gastric mucosa.
文摘AIM： To evaluate whether adding azithromycin to firstline Helicobacter pylori （H pylorl） eradication improved eradication and reduced side effects. METHODS： Eligible articles were identified by searches of electronic databases. We included all randomized trials that compared azithromycin-containing with standard triple-therapy regimens for first-line treatment of H pylori infection. Statistical analysis was performed with Review Manager 5.0.10. Sub-analyses were also performed. RESULTS： We identified 14 randomized trials （1431 patients）. Pooled Hpylori eradication rates were 72.01% （95% CI： 58.09%-85.93%） and 69.78% （95% CI： 66.47%-73.09%） for patients with or without azithromycin by intention-to-treat analysis, and the odds ratio （OR） was 1.17 （95% CI： 0.64-2.14）. The occurrence of side effects differed significantly and was 15.81% （95% CI： 12.50%-19.12%） and 25.20% （95% CI： 21.44%-28.96%） for treatment with or without azithromycin, respectively, and the summary OR was 0.58 （95% CI： 0.41-0.82）. Furthermore, the azithromycin-containing group had a lower occurrence of diarrhea, nausea and taste disturbance. CONCLUSION： Our review suggests that azithromycincontaining triple-therapy regimens could be equally effective in eradication of Hpylori compared with standard first-line triple-therapy regimens.
文摘Aim To evaluate the efficacy and cost-effectiveness of one-week regiment of quadruple and triple therapy containing:Lansoprazle(L),colloidal bismuth subciteate(B),amoxicillin(A),metrnidozole(M) and furazolidone(F).Methods 227 patients with duodenal ulcer(DU) or non-ulcer dyspepsia (NUD) confirmed by endoscopy were received LAFB,LAM or LAF,twice daily for 7 days.Endoscopy was performed in DU and 14 C-UBT was performed in NUD 4 weeks after completion of treatment.Results (1)The eradication rate of H.pylori by LAFB,LAM and LAF were 96.30%,84.51% and 70.59% respectively(LAFB vs LAF and LAF,P<0.05;LAFB vs LAM P<0.01).The healing rate of DU had no difference between three regiment P<0.05).The cost-effectiveness analysis on eradication of H.pylori showed that cost/effectiveness (C/E) of LAFB is the lowest.(2)The healing rate of DU ulcer in H.pylori eradicated patients was higher than that in uneradicated ones(98.94% vs 50%,P<0.01).The rate of ulcer recurrent of year was lower in H.pylori eradicated patients than that in uneradicated patients(2.15% vs 71.42%,P<0.01).(3)The rate of relieving symptom and recurrenting symptom in one year had no difference between H.pylori eradicated patients and uneradicated patiens in NUD(71.74% vs 70% and 53.03 vs 50,P>0.05).Conclusions The efficacy of one week regiment of quadruple therapy is higher than that in triple therapy but the side effect was not higher.The higher eradication rate is caused by combination of furazolidone,bacause it is low resis tant to H.pylori.It is also a cost-saving strategy.Eradication of H.pylori infection could improve ulcer healing and decrease the rate of ulcer recurrent but is not likely to relieve symptomes in NUD patients.
