益生菌辅助含铋剂四联疗法根除幽门螺杆菌的临床研究

目的 探讨益生菌联合铋剂四联疗法能否在一定程度上提高幽门螺杆菌根除率,同时缩短根治幽门螺杆菌用药时间,降低抗菌药使用过程中的相关不良反应.方法 选取2018年1月1日—2019年4月30日在温州医科大学附属第二医院消化内科就诊,并经证实存在幽门螺杆菌感染者600例,随机分为4组,每组150例.A组:予阿莫西林胶囊1.0...

Clinical study on probiotics auxiliary bismush quadruple therapyfor Helicobacter pylori eradication*

Objective To explore whether probiotics auxiliary bismuth quadruple therapy can effectivelyimprove the eradication rate of H.pylori, and whether can shorten the medication time for H.pylori and reduce therelated adverse reactions during the use of antibacterial drugs. Methods Six hundred H. pylori-infected patientswere selected and randomly divided into four groups. Group A: the total course of treatment is 10 days, withamoxicillin capsule 1.0 g bid, clarithromycin sustained release tablets 500mg bid, rabeprazole sodium enteric-coated tablets 20 mg bid, olloidal pectin bismuth capsule 200 mg bid; group B: the total course of treatment is 14 days andthe medication plan is the same as group A; group C: the total course of treatment is 10 days, and the compoundLactobacillus acidophilus tablets 1.0 g tid was added to the group A regimen; group D: The total course of treatmentis 14 days, and the medication plan is the same as group C. After 4 to 8 weeks of treatment, 13C-UBT was performed,and the negative ones were judged to be successful in the radical treatment of H.pylori. Finally, the eradication rateof H.pylori and the incidence of adverse reactions among the four groups were compared. Results According to theintent-to-treat analysis (ITT analysis), the comparisons of eradication rate between group A and group B, group Aand group C, group A and group D, group C and group D were statistically significant (P < 0.007), the differencesbetween group B and group C, group B and group D were not statistically significant (P > 0.007). According to theperprotocol analysis (PP analysis) method, the differences of eradication rate between group A and group B, group Aand group C, group A and group D, group C and group D were statistically significant (P < 0.007), but no significantdifference was found between group B and group C, group D (P > 0.007). The incidences of abdominal distension,nausea, and diarrhea in group A were significantly higher than those in group C, and the differences were statisticallysignificant (P < 0.007). Compared with group D, group B had a higher incidence of abdominal distension, anorexia,and diarrhea, and the difference was statistically significant (all P < 0.007). The incidences of bloating, nausea,diarrhea, and constipation were significantly higher in Group B than in group C, and the differences were statisticallysignificant (P < 0.007). The difference was not statistically significant in the incidences of rash, headache, and tasteabnormalities among the groups (P > 0.05). Conclusion Probiotics auxiliary bismuth quadruple therapy caneffectively improve the eradication rate of H.pylori up to a point. For some areas with low resistance to antibiotics, itis also possible to effectively shorten the time of administration, and probiotics can also reduce the gastrointestinalside effects that occur during the use of antibacterials.