益生菌联合三联疗法根除幽门螺杆菌疗效研究

目的 评价复方嗜酸乳杆菌片与布拉酵母菌(Saccharomyces boulardii,S.Boulardii)散剂联合三联疗法根除幽门螺杆菌(Helicobacter pylori,H.pylori)的有效性和安全性.方法 H.pylori阳性患者240例随机分为3组,A组:埃索美拉唑20 mg+阿莫西林1 000 mg+呋喃唑酮100 mg,口服每日2次,疗程10天;B组:在A组三联10天基础上,加用复方嗜酸乳杆菌片1 000 mg,口服每日3次,总疗程14天;C组:在A组三联10天基础上,加用S.Boulardii散剂500mg,口服每日2次,总疗程14天.治疗期间观察患者不良反应发生情况,疗程结束4周后观察H.pylori根除率.结果 A、B、C组H.pylori根除率按意向性(ITT)分析分别为62.5％、76.2％、83.8％,按方案(PP)分析分别为64.1％、79.2％、85.9％,B组、C组PP根除率明显高于A组(P＜0.05),C组ITT和PP根除率与B组比较差异无统计学意义(P＞0.05).不良反应发生率方面,B、C组明显低于A组(19.5％、7.7％ vs 34.6％,P＜0.05),C组明显低于B组(P＜0.05).B、C组对药物的耐受程度明显高于A组(P＜0.05),B组与C组差异无统计学意义(P＞0.05).结论 复方嗜酸乳杆菌片或S,Boulardii散剂联合三联疗法均可提高H.pylori根除率,后者安全性优于前者.

Therapeutic effect of probiotics combined with triple therapy for Helicobacter pylori eradication

Objective To assess the efficacy and safety of compound eosinophil-lactobacillus tablets or Saccharomyces boulardii （S. Boulardii） Sachets combined with standard triple therapy for Helicobacter pylori （H. pylori） eradication. Methods A total of 240 H. pylori- infected patients were enrolled and randomly assigned into three groups. Group A received esomeprazole （20 mg,bid） ＋ amoxicillin （1 000 mg,bid） ＋ furazolidone （100 mg,bid）,for 10 days. Group B received the same triple therapy for 10 days as group A,and plus compound eosinophil-lactobacillus tablets （1 000 mg, tid） for 14 days. Group C received the same triple therapy for l0 days as group A, and plus S. Boulardii Sachets （500 mg,bid） for 14 days. During the therapy, the adverse reactions in patients were observed. Four weeks after the course of treatment, H. pylori eradication rates were assessed. Results The H. pylori eradication rates by intention-to-treat（ITT） analysis in groups A, B and C were 62.50%, 76.2 %, 83.8 %, respectively; by per-protocol （PP） analysis,they were 64.1%,79.2%,85.9%,respectively. The H. pylori eradication rates in group B and C were significantly higher than that in group A by PP analysis（ P 〈0.05） ,but no significant difference was seen in group C and B by ITT and PP analysis（ P 〈0.05）. The incidence of adverse reactions was significantly lower in group B and group C than that in group A （19.5% ,7.7% vs 34.6%, P 〈0.05） ,group C was significantly lower than that in group B（ P 〈0.05）. The drug tolerance in group B,group C was significantly higher than that in group A（ P 〈0.05） ,and there was no significant difference between group B and group C （ P 〉 0.05）. Conclusion Compound eosinophil- lactobacillus tablets or S. Boulardii Sachets combined with triple therapy can increase the eradication rate of H. pylori with higher safety, the latter is more secure than the former.