复方嗜酸乳杆菌片在幽门螺杆菌根除失败补救方案中作用的研究  

Use of Compound Lactobacillus acidophilus Tablets in Rescue Therapy for Failed Eradication of Helicobacter pylori

作　　者：王芳军[1] 高昳 刘鹏飞[1] 项斌[1] 沈卫东[1] 张伟[1] 夏挺松[1] 

机构地区：[1]东南大学医学院附属江阴医院消化科,214400

出　　处：《胃肠病学》2014年第5期284-287,共4页Chinese Journal of Gastroenterology

基　　金：2011年江苏省药学会研课题(No:201005)资助

摘　　要：幽门螺杆菌(Hp)感染与慢性胃炎、消化性溃疡、胃黏膜相关淋巴样组织淋巴瘤和胃癌等疾病的发生有关。有研究显示,联合使用嗜酸乳杆菌能提高Hp根除率,并降低治疗过程中的不良反应。目的:探讨复方嗜酸乳杆菌片联合含铋剂四联疗法对首次根除失败的Hp感染的疗效。方法:将180例经标准三联疗法首次根除失败的Hp阳性的消化性溃疡患者随机分为试验组和对照组,试验组患者给予复方嗜酸乳杆菌片1 g tid,餐后服用,疗程14 d,然后给予雷贝拉唑10 mg bid+阿莫西林1 000 mg bid+呋喃唑酮100 mg bid+枸橼酸铋钾300 mg qid,疗程10 d。对照组患者给予雷贝拉唑10 mg bid+阿莫西林1 000 mg bid+呋喃唑酮100 mg bid+枸橼酸铋钾300 mg qid,疗程10 d。治疗结束至少4周后行^(13)C-尿素呼气试验,评估Hp根除率和不良反应。结果:试验组PP根除率和ITT根除率与对照组相比均无明显差异(PP:81.2%对78.2%,χ~2=0.241,P=0.623;ITT:76.7%对75.6%,χ~2=0.031,P=0.861)。试验组恶心呕吐(2.4%对11.5%)、腹泻(0对9.2%)的发生率明显低于对照组(P<0.05)。结论:复方嗜酸乳杆菌片联合含铋剂四联疗法对首次标准三联疗法根除失败的Hp患者疗效较好,同时可有效减少不良反应。Background：Helicobacter pylori （Hp）infection is correlated with the development of chronic gastritis,peptic ulcer, mucosa-associated lymphoid tissue lymphoma and gastric cancer.Studies showed that Lactobacillus acidophilus could improve the eradication rate of Hp and reduce the occurrence of side-effects.Aims：To evaluate the efficacy of compound Lactobacillus acidophilus tablets combined with bismuth-containing quadruple therapy for the treatment of failed eradiction of Hp infection.Methods：One hundred and eighty patients with Hp-positive peptic ulcer in whom standard triple therapy failed were enrolled and then randomly assigned into experimental group and control group.Patients in experimental group received compound Lactobacillus acidophilus tablets 1 g tid for 14 days,followed by rabeprazole 10 mg bid ＋amoxicillin 1 000 mg bid ＋furazolidone 100 mg bid ＋bismuth 300 mg qid for 10 days.Patients in control group received rabeprazole 10 mg bid ＋amoxicillin 1 000 mg bid ＋furazolidone 100 mg bid ＋bismuth 300 mg qid for 10 days.13 C-urea breath test was conducted at least 4 weeks after completion of the course,Hp eradication rate and side-effects were evaluated. Results：No significant differences in PP eradication rate and ITT eradication rate were found between experimental group and control group （PP：81.2% vs.78.2%,χ2 =0.241,P =0.623;ITT：76.7% vs.75.6%,χ2 =0.031,P =0.861）.Incidences of nausea and vomiting （2.4% vs.11.5%）,diarrhea （0 vs.9.2%）in experimental group were significantly decreased than those in control group （P 〈0.05）.Conclusions：Compound Lactobacillus acidophilus tablets combined with bismuth-containing quadruple therapy is efficient for Hp-positive patients with failed standard triple therapy and can reduce side-effects.

关 键 词：幽门螺杆菌 嗜酸乳杆菌 铋 补救治疗 

分 类 号：R573[医药卫生—消化系统]