序贯疗法和加用益生菌对幽门螺杆菌感染的疗效观察

目的评估序贯疗法和序贯疗法联合益生菌根除Hp感染的疗效和安全性。方法 360例Hp感染伴消化不良者随机入选序贯疗法组和序贯疗法联合益生菌组,序贯疗法组前5 d予埃索美拉唑＋阿莫西林治疗,后5 d予埃索美拉唑＋克拉霉素＋甲硝唑治疗。序贯疗法联合益生菌组在序贯疗法治疗的基础上每天给予双歧杆菌三联活菌治疗。治疗结束至少停药4周后复查13C尿素呼气试验,结果阴性,表示根除成功。同时评估疗效及安全性。对Hp根除率进行意向性分析和符合方案分析比较。结果按意向性分析,序贯疗法组Hp根除率为81.1%（146/180）,加用益生菌组为93.9%（169/180）,差异有统计学意义（χ^2=13.4,P〈0.01）;按符合方案分析,序贯疗法组Hp根除率为83.0%（146/176）,加用益生菌组为94.9%（169/178）,差异有统计学意义（χ^2=13.0,P〈0.01）。结论加用益生菌治疗可改善序贯疗法根除Hp的疗效。

Sequential therapy combined with probiotics for eradication of helicobacter pylori

Objective To compare the efficacy and safety of sequential therapy combined with probiotics in helicobacter pylori（Hp） eradication. Methods A total of 360 Hp positive patients with dyspepsia were recruited and randomly assigned into sequential therapy and sequential therapy combined with probiotics groups. The patients in sequential therapy group received esomeprazole with amoxicillin for five days, and then esomeprazole with clarithromycin and metronidazole for another five days. In addition the patients in sequential therapy combined with probiotics group received probiotics for ten days. The 13C-urea breathe test was reexamined at 1east 4 weeks after the completion of treatment, the result with Hp negative indicated the success of Hp eradication. The efficacy and safety were also evaluated. Hp eradication rates were compared with the intention-to-treat（ITT） and per protocol（PP） analysis. Results According to ITT analysis, the eradication rates of Hp in sequential therapy group and sequential therapy combined with probiotics group were 81.1%（146/180） and 93.9%（169/180） respectively. According to PP analysis, the eradication rates of Hp in sequential therapy group and sequential therapy combined with probiotics group were 83.0%（146/176） and 94.9%（169/178） respectively. Whether with ITT analysis or with ITT analysis, the Hp eradication rate in the sequential therapy group was lower than that of the sequential therapy combined with probiotics group. There was significant difference. ConclusionCombing with probiotics can improve the efficacy and safety of sequential therapy.