地衣芽孢杆菌联合PPI三联疗法根除幽门螺杆菌的临床疗效  

Efficacy of Bacillus licheniformis combined with PPI triple therapy in eradication of Helicobacter pylori

作　　者：蒋永爱[1] 欧希龙[1] 王建宁[2] 

机构地区：[1]东南大学医学院,江苏省南京市210015 [2]南京市江宁医院消化科,江苏省南京市211100

出　　处：《世界华人消化杂志》2013年第9期840-844,共5页World Chinese Journal of Digestology

摘　　要：目的:观察地衣芽孢杆菌联用标准三联疗法对幽门螺杆菌(Helicobacter pylori,H.pylori)的根治率、临床症状改善率的影响.方法:选择我院经胃镜检查,快速尿素酶法及病理活检染色诊断确诊为糜烂性胃炎或消化性溃疡并伴有H.pylori感染的患者120例,随机分成3组:对照组1(A组,三联组,n=40例)予以兰索拉唑30mgbid+阿莫西林1.0bid+左氧氟沙星0.5qd;对照组2(B组,四联组,n=40例)予以果胶铋0.2bid+三联组);治疗组(C组,地衣芽孢杆菌+三联,n=40例)予以地衣芽孢杆菌0.5bid+三联组.对照组疗程均为7d,治疗组治疗7d后,继续服用地衣芽孢杆菌胶囊(整肠生)14d.另外胃溃疡患者治疗1wk后继续服用兰索拉唑30mg,1次/d,5wk;十二指肠溃疡患者治疗1wk后继续服用兰索拉唑30mg,1次/d,3wk.结果:地衣芽孢杆菌组对H.pylori根除率明显高于标准三联组(85.0%vs70.0%,P<0.05)、而和铋四联组比较,无显著性差异(85.0%vs82.5%,P>0.05);地衣芽孢杆菌组对患者临床症状缓解明显高于对照组1(标准三联组)(97.5%vs75.0%,P<0.05)、而与对照组2(铋四联组)比较,无明显差异(97.5%vs95.0%,P>0.05);地衣芽孢杆菌组不良反应发生率低于明显对照组1(2.5%vs12.5%,P<0.05)和对照组2(2.5%vs25.0%,P<0.05).结论:地衣芽孢杆菌能提高标准三联疗法H.pylori根除率,明显缓解患者临床症状,减少不良反应的发生率.AIM： To observe the effect of Bacillus licheniformis in combination with PPI triple therapy on the cure rate of Helicobacter pylori （H. pylori） and improvement of clinical symptoms.METHODS： One hundred and twenty patients who were diagnosed with erosive gastritis or peptic ulcer with H. pylori infection by gastros-copy, rapid urease method and pathological staining at our hospital were randomly divided into three groups： triple therapy group （n = 40, treated with lansoprazole 30 mg bid ＋ amoxicillin 1.0 bid ＋ levofloxacin 0.5 QD）, quadruple therapy group （n = 40, treated with bismuth pectin 0.2 bid ＋ lansoprazole 30 mg bid ＋ amoxicillin 1.0 bid ＋ levofloxacin 0.5 QD）, and combination treatment group （n = 40, treated with Bacillus licheniformis 0.5 bid ＋ lansoprazole 30 mg bid ＋ amoxicillin 1.0bid ＋ levofloxacin 0.5 QD）. The triple therapy and quadruple therapy groups were treated for 7 d, and the treatment group continued taking Bacillus licheniformis capsules for an additional 14 d. Patients with gastric ulcer continued taking LAN 30 mg, once daily for 5 wk, and those with duodenal ulcer continued taking lansoprazole 30 mg, once daily for 3 wk.RESULTS： H. pylori eradication rate was signifi-cantly higher in the Bacillus licheniformis group than in the triple therapy group （85% vs 70%, P 0.05）, but showed no significant difference between the Bacillus licheniformis group and qua-druple therapy group （85% vs 82.5%, P 0.05）. The clinical symptoms were improved more significantly in the Bacillus licheniformis group than in the triple therapy group （97.5% vs 75.0%, P 0.05）; however, there was no significant difference in the percentage of patients showing symptom improvement between the Bacil-lus licheniformis group and quadruple therapy group （97.5% vs 95.0%, P 0.05）. The incidence of adverse reactions was significantly lower in the Bacillus licheniformis group than in the triple therapy group （2.5% vs 12.5%, P 0.05） and quadruple therapy group 2 （2.5% vs

关 键 词：糜烂性胃炎 消化性溃疡 地衣芽孢杆菌 幽门螺杆菌 根除率 不良反应 

分 类 号：R57[医药卫生—消化系统]