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1.
幽门螺杆菌(Helicobacter pylori,H.pylori)感染与上胃肠道疾病密切相关。由于H.pylori对抗生素耐药率的增加及根除治疗过程中不良反应的出现,导致标准三联疗法H.pylori根除率逐渐下降。益生菌辅助治疗H.pylori感染已取得一些成果,其在提高H.pylori根除率、降低不良反应中的作用日益受到重视。在H.pylori根除治疗中何时加用益生菌、加用何种益生菌成为国内外研究的热点,益生菌的疗效很大程度上依赖于菌种或菌株类型。益生菌还具有维持胃肠道微生态的稳定、减轻黏膜炎症反应等多种作用,本文对益生菌在根除H.pylori治疗中的作用机制及临床意义、益生菌在降低H.pylori治疗相关不良反应中的作用作一概述。  相似文献   

2.
幽门螺杆菌(Helicobacter pylori,H.pylori)感染是引起胃肠道多种疾病的重要因素。随着抗生素耐药率的逐年上升,H.pylori感染已经成为一个公认的全球健康问题。非抗生素类药物,如益生菌、胃黏膜保护剂、中草药和抗菌肽等的发展对H.pylori的防治提供新思路。本文就非抗生素类药物在H.pylori根除中的应用作一概述。  相似文献   

3.
目的探讨幽门螺杆菌(H.pylori)根除性治疗对慢性胃炎的治疗价值及对胃泌素和细胞因子的影响。方法选择80例慢性胃炎H.pylori阳性的患者为研究对象,随机分为观察组和对照组,对照组采用常规三联抗H.pylori治疗,观察组在对照组的基础上采用益生菌四联抗H.pylori治疗,比较两组患者的治疗效果、H.pylori根除率、胃泌素及细胞因子的变化、不良反应等。结果观察组治疗后疗效均高于对照组,H.pylori根除率高于对照组,差异具有统计学意义(P0.05)。观察组治疗后的临床症状评分、胃镜评分均低于对照组,胃泌素、炎性因子TNF-α、CRP、IL-6均低于对照组(P0.05)。观察组的不良反应少于对照组(P0.05)。结论采用益生菌四联抗H.pylori治疗能够提高慢性胃炎的治疗效果,缓解患者的临床症状,可能与减轻炎症反应和胃泌素分泌有关,且联用益生菌能够降低不良反应。  相似文献   

4.
目的:对益生菌增效治疗幽门螺杆菌(Helicobacter pylori,H.pylori)感染的系统评价/Meta分析进行再评价研究.方法:计算机检索CBM、CNKI、Wanfang Data、VIP Data、the Cochrane library、PubMed、Embase数据库,收集关于益生菌增效治疗H.pylori感染的系统评价/Meta分析文章,检索时间均从建库至2014-10.由两位研究者按照纳入排除标准独立筛选文献、提取资料后,采用OQAQ(Overview Quality Assessment of Questionnaire)量表评价纳入研究质量,并采用GRADE(Grade o f R e c o m m e n d a t i o n,A s s e s s m e n t,Development,and Evaluation)系统进行证据质量分级.结果:共纳入11个相关Meta分析,11个研究均评价了益生菌增效治疗H.pylori的根除率及总不良反应发生率,其中3个研究详细评价了抗H.pylori具体不良反应发生率,OQAQ平均得分3.82分.GRADE系统的证据质量评价结果显示证据质量等级普遍较低.结论:当前益生菌增效治疗H.pylori感染具有一定的优势,但Meta分析的总体质量较差,证据水平较低,临床医生应根据实际情况进行循证决策.  相似文献   

5.
幽门螺杆菌(Helicobacter pylori,H.pylori)感染与多种上胃肠道疾病相关,根除H.pylori可以降低胃癌发生风险,随着H.pylori对抗生素耐药问题的日益严重,应用常规抗生素疗法治疗失败的患者也日益增多,而对于多次治疗失败的难治性H.pylori感染患者,如何提高患者的治疗成功率,已成为细菌抗生素耐药时期的一个挑战。中国相关共识推荐,可以将中药用于H.pylori感染的治疗,而采用中西医结合治疗H.pylori相关疾病,是目前H.pylori相关疾病治疗研究领域的热点之一。本文报道1例历经19次治疗失败的难治性H.pylori感染患者,经过给予精心设计的中西医结合治疗方案治疗,使患者的H.pylori最终成功获得根除。  相似文献   

6.
幽门螺杆菌(H.pylori)与多种胃肠道疾病密切相关,在人群中的感染率较高,目前的"三联"或"四联"抗H.pylori治疗由于治疗费用、抗生素耐药等受到一定限制,为了有效控制H.pylori感染,疫苗尤其是核酸疫苗的研制逐渐成为该研究领域的热点,被认为是防治H.pylori最有前景的方法.  相似文献   

7.
幽门螺杆菌(H.pylori)与多种胃肠道疾病密切相关,在人群中的感染率较高,目前的“三联”或“四联”抗H.pylori治疗由于治疗费用、抗生素耐药等受到一定限制,为了有效控制H.pylori感染,疫苗尤其是核酸疫苗的研制逐渐成为该研究领域的热点,被认为是防治H.pylori最有前景的方法。  相似文献   

8.
幽门螺杆菌(Helicobacter pylori,H.pylori)感染与胃炎、胃溃疡、胃癌等疾病密切相关。H.pylori在我国的感染率、耐药率高,根除率低,且根除后再感染率高,因此,强化H.pylori感染者根除治疗对降低我国H.pylori感染率具有重要意义。2017年我国H.pylori处理共识中建议首选铋剂四联疗法进行经验性治疗,近年也有不少新策略被提出,如辅以益生菌、中医中药、疫苗等方案。最佳的H.pylori治疗方案应结合药敏试验、地区耐药率、个人抗生素暴露史、PPI基因型、经济效益比等多方面综合考虑,做到"个体化精准治疗"尤为重要。为此,本文就H.pylori感染现状及当前治疗现状作一概述。  相似文献   

9.
中国幽门螺杆菌耐药研究现状   总被引:33,自引:0,他引:33  
中国是一个幽门螺杆菌(H.pylori)感染率较高的国家,H.pylori的感染率42%~90%,所以H.pylori感染的治疗是H.pylori研究领域中的重点,而H.pylori感染治疗失败主要原因是H.pylori对抗生素的耐药性,所以H.pylori感染治疗中核心问题是日.pylori对抗生素的耐药性,其耐药性也是H.pylori感染研究中的重点课题。近年我国对H.pylori耐药研究已有新j生展,本文重点介绍如下5个方面:①H.pylori对常用抗生素耐药情况及地区差异性;②H.pylori对常用抗生素耐药性随时间变迁而逐渐上升;⑧H.pylori对四环素和左氧氟沙星耐药情况;④H.pylori耐药对H.pylori根除效果的影响;⑤如何克服H.pylori对抗生素耐药性。  相似文献   

10.
目的探讨益生菌联合四联疗法在H.pylori感染中的治疗效果及提高根除率的价值。方法以收入医院治疗的120例浅表性胃炎H.pylori(+)患者为研究对象,采用前瞻性研究,随机分为观察组与对照组,每组60例。两组患者均给予四联疗法(雷贝拉唑+阿莫西林+左氧氟沙星+枸橼酸铋钾)治疗,观察组在此基础上增加益生菌(培菲康)治疗,比较两组H.pylori根除率、病症缓解率、临床症状评分与不良反应发生率。结果观察组H.pylori根除率为91.67%,高于对照组的76.67%(P0.05);两组治疗后临床症状评分均较治疗前降低,且观察组治疗后1、2周临床症状评分均低于对照组(P0.05);观察组不良反应发生率为8.33%,低于对照组的21.67%(P0.05)。结论在四联疗法的基础上增加益生菌治疗胃炎不但可提高治疗效果,提高H.pylori根除率,缓解患者临床症状,且用药后出现不良反应的情况较少,安全性高,说明益生菌联合四联疗法在H.pylori相关性胃炎治疗中具有可观的应用前景,值得基层医院应用并推广。  相似文献   

11.
Probiotics and Helicobacter pylori   总被引:4,自引:0,他引:4  
There is substantial evidence that probiotics modulate Helicobacter pylori colonization of the gastric mucosa. This chapter presents the data currently available to support an interaction between probiotics and H. pylori, the importance of lactic acid production by probiotics and their capacity to release bacteriocins or secrete antibiotics. The ability of probiotics to interfere with H. pylori adhesion to epithelial cells and their capacity to attenuate H. pylori-induced gastritis in man is addressed. Finally, the potential of probiotics to modify the H. pylori eradication rate and the antibiotic-associated gastrointestinal side-effects during H. pylori eradication therapy are reviewed.  相似文献   

12.
After the discovery of Helicobacter pylori(H. pylori), and the evidence of its relationship with gastric diseas-es, antibiotic-based therapies were developed, which efficacy was however limited by antibiotic resistance and lack of patient compliance. A vaccine would over-come these drawbacks, but currently there is not any H. pylori vaccine licensed. In the frame of the studies aimed at finding alternative therapies or at increasing the efficacy of the current ones and/or reducing their side effects, the investigation on the use of probiotics plays an interesting role. In vitro and preclinical stud-ies have shown the feasibility of this approach. Several clinical trials indicated that administration of probiot-ics can reduce the side effects of H. pylori eradication treatment, increasing tolerability, and often increases the overall efficacy. The results of these trials vary, likely reflecting the variety of probiotics assessed and that of the eradication treatment, as well as the differ-ences in the geographic area that imply different H. py-lori strains distribution, host susceptibility, and therapy efficacy. In conclusion, the use of probiotics appears promising as an adjuvant for the current H. pylori erad-ication treatment, though it still requires optimization.  相似文献   

13.
BACKGROUND: Current antibiotic treatment for Helicobacter pylori infection is often associated with frequent adverse effects and resistance to antibiotics. Alternative treatment methods to control H. pylori infection are needed. Some specific strains of lactic acid bacteria (probiotics) in dairy products are known to inhibit the growth of H. pylori in vitro. A clinical trial was conducted to see the efficacy of a specially designed yogurt product containing specific probiotics on the eradication of H. pylori. METHOD: The yogurt was prepared using three Lactobacillus spp. (L. acidophilus and L. casei) and one commercial starter culture (L. acidophilus, L. bulgaricus and Streptococcus thermophilus). All these cultures were previously evaluated, and found to have strong in vitro inhibitory effects on the growth of H. pylori. Twenty-seven asymptomatic women positive for H. pylori on gastric biopsy and 13C urea breath test were recruited, and administered 175 ml of the yogurt three times a day for 30 days. The 13C urea breath test was administered again, one month after stopping the yogurt treatment to detect the presence of H. pylori. RESULTS: In 26 of 27 subjects, the urea breath test values remained positive, indicating that the consumption of the yogurt had no effect on the eradication of H. pylori. CONCLUSION: Although the designed fermented milk containing lactobacilli is very effective in the inhibition of H. pylori growth in vitro, eradication of this infection in humans is difficult to achieve by consuming this product.  相似文献   

14.
Helicobacter pylori(H. pylori) is considered an etiologic factor for the development of peptic ulcer disease,gastric adenocarcinoma, and MALT lymphoma.Therapeutic schemes to eradicate the bacteria are based on double antibiotic therapy and proton pump inhibitor. Despite many therapeutic improvements in H. pylori eradication treatment, it is still associated with high infection rate also in developed countries.Bacterial resistance and adverse events occurrence are among most frequent causes for anti- H. pylori treatment failure. Several studies have reported that certain probiotic strains can exhibit inhibitory activity against H. pylori bacteria. In addition, some probiotic strains can reduce the occurrence of side effects due to antibiotic therapy and consequently increase the H.pylori eradication rate. The results of the prospective double-blind placebo-controlled studies suggest that specific probiotics, such as S. boulardii and L.johnsonni La1 probably can diminish the bacterial load,but not completely eradicate the H. pylori bacteria.Furthermore, it seems that supplementation with S. boulardii is a useful concomitant therapy in the standard H. pylori eradication treatment protocol and most probably increases eradication rate. L. reuteri is equally effective, but more positive studies are needed. Finally, probiotic strains, such as S. boulardii,L. reuteri and L. GG, decrease gastrointestinal antibiotic associated adverse effects.  相似文献   

15.
Infection with H pylori is the most important known etiological factor associated with gastric cancer. While colonization of the gastric mucosa with H pylori results in active and chronic gastritis in virtually all individuals infected, the likelihood of developing gastric cancer depends on environmental, bacterial virulence and host specific factors. The majority of all gastric cancer cases are attributable to H pylori infection and therefore theoretically preventable. There is evidence from animal models that eradication of H pylori at an early time point can prevent gastric cancer development. However, randomized clinical trials exploring the prophylactic effect of H pylori eradication on the incidence of gastric cancer in humans remain sparse and have yielded conflicting results. Better markers for the identification of patients at risk for H pylori induced gastric malignancy are needed to allow the development of a more efficient public eradication strategy. Meanwhile, screening and treatment of H pylori in first-degree relatives of gastric cancer patients as well as certain high-risk populations might be beneficial.  相似文献   

16.
The evidence supporting the important role of Helicobacter pylori causing gastric cancer is getting stronger. The mechanisms by which H. pylori can influence the progression to severe changes in the gastric mucosa are under investigation. An increased gastric epithelial cell proliferation has been observed in individuals infected with H. pylori. This lifelong increased cell turnover is deemed to be a major risk factor for increased mutational changes and may lead to the development of gastric cancer. Successful eradication of H. pylori infection induces the healing of the gastritis and a significant decrease in gastric epithelial cell proliferation. Nevertheless, it is right now unknown at which time the point of no return, meaning at which time an eradication therapy leads to a benefit for the individual to prevent gastric cancer, has been reached. Therefore the major question that arises is to whom an eradication therapy should be offered to prevent gastric cancer. A general elimination of the infection might be worthwhile, but seems to be unrealistic now because of the high prevalence of the infection and the missing of a vaccine. This review reflects possible mechanisms of gastric cancer development induced by chronic H. pylori infection and recent investigational trials for prevention of gastric cancer by H. pylori eradication therapy will be discussed.  相似文献   

17.
Epidemiologically, the association between chronic Helicobacter pylori infection and development of gastric cancer is well established. Although the possibility of preventing gastric cancer by eradicating H. pylori infection was recently investigated by several research groups, the results remain controversial. The aim of this study was to determine whether the eradication of H. pylori infection would reduce the incidence of gastric cancer. In total, 304 patients with persistent H. pylori infection and 404 patients with H. pylori infection eradicated were examined annually for gastric cancer by endoscopy. Over an average of 3.1 years for the first group and 3.2 years for the second group, 13 and 6 patients, respectively, were diagnosed as having new gastric cancer. The cumulative incidence of gastric cancer was statistically different between the groups (P=0.019; log-rank test). The hazard ratio of H. pylori eradication was 0.335 by Cox proportional hazards model (P=0.047). Differentiated gastric cancer was found in 11 patients in the persistent infection group and 3 patients in the eradicated group. The incidence of differentiated cancer was significantly different (P=0.017) between the groups, but not for undifferentiated cancer (P=0.847). The results of the current study suggest that the eradication of H. pylori infection reduces the incidence of gastric cancer.  相似文献   

18.
BACKGROUND AND AIM: Infection of Helicobacter pylori is viewed as a major driver of progression to the precancerous state or to gastric cancer. This study was performed to investigate the effect of H. pylori infection on gastric cancer development and to determine to what extent H. pylori eradication is likely to reduce the prevalence of gastric cancer. METHODS: Gastric cancer development was investigated in 1790 Korean subjects who underwent gastroscopy and H. pylori testing between 1992 and 1998. The effects of H. pylori-positive and eradicated states on gastric cancer development were analyzed. RESULTS: Gastric cancer developed in 5 of the study cohort during a mean follow-up period of 9.4 years. All of these patients were positive for H. pylori infection, and 4 of the 5 had antral intestinal metaplasia (IM) at the time of study enrollment. One of these 5 patients was in an eradicated state when the gastric cancer was diagnosed, and had histologic IM before eradication therapy was performed. Gastric cancer was found to develop 10.9 times more frequently in the presence of IM than in its absence. CONCLUSIONS: The present study shows a close relationship between H. pylori infection and IM, and between IM and the development of gastric cancer. In addition, our finding suggests that chronic H. pylori infection looks like an important risk factor for the development of gastric cancer in Korea, where the prevalence of H. pylori remains high. This study indicates that to prevent gastric cancer H. pylori eradication is best performed before the development of IM.  相似文献   

19.
This article describes the characteristics of H. pylori infection dynamics in early gastric cancer cases in Japan and the reduced likelihood of metachronous cancer development and growth inhibition by H. pylori eradication based on healing of background gastric mucosa. In the future, these clinical studies and experimental studies in Mongolian gerbils and mice should elucidate the role of H. pylori infection in the development of gastric carcinogenesis to clinical cancer on the genetic level so that gastric cancer prevention by H. pylori eradication is established.  相似文献   

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