标准三联加益生菌疗法和铋剂四联方案治疗幽门螺杆菌感染的对照研究  

Control study on standard triple therapy combined with probiotics and bismuth quadruple therapy in treatment of anti-Helicobacter pylori eradication

作　　者：谢睿[1] 杨晓钟[1] 高成城[1] 吴尚农[1] 马天恒[1] 

机构地区：[1]南京医科大学附属淮安第一医院消化科,淮安223300

出　　处：《山西医科大学学报》2014年第12期1180-1182,共3页Journal of Shanxi Medical University

摘　　要：目的探讨标准三联加益生菌疗法和铋剂四联方案在根除幽门螺杆菌治疗中对根除率和不良反应的影响。方法 150例Hp检查阳性的慢性活动性胃炎患者分为3组,每组50例。A组:给予三联疗法(克拉霉素+阿莫西林+雷贝拉唑)+双歧杆菌三联活菌胶囊;B组:给予四联疗法(克拉霉素+阿莫西林+雷贝拉唑+枸橼酸铋钾);C组:给予三联疗法;疗程均为10 d。治疗结束后4周复查13C-尿素呼气试验(13C-UBT)以评估Hp根除疗效,期间观察患者不良反应发生情况。结果 139例患者按方案完成治疗。A、B、C组按意向治疗(ITT)分析Hp根除率分别为78.0%,76.0%,56.0%,按方案(PP)分析Hp根除率分别为81.3%,86.4%,59.6%,A、B组ITT和PP根除率均显著高于C组(P<0.05),ITT和PP根除率A组与B组比较差异无统计学意义(P>0.05)。A组不良反应发生率显著低于B组和C组(33.3%vs 61.4%和55.3%,P<0.05),B组与C组比较差异无统计学意义(P>0.05)。A组对药物的耐受程度显著高于B组和C组(P<0.05)。结论标准三联加益生菌疗法和铋剂四联方案均能大大提高Hp根除率,而加用益生菌能降低不良反应的发生率。Objective To explore the effects of standard triple therapy combined with probiotics versus bismuth quadruple therapy on the eradication rates and adverse effect in anti-Helicobacter pylori （Hp）therapy.Methods A total of 150 Hp-infected patients with chronic active gastritis diagnosed by 13 C-urea breath test（13 C-UBT）were enrolled and randomly assigned into three groups.Patients in group A were given standard triple therapy（clarithromycin,amoxicillin and rabeprazole）combined with bifid-triple viable capsules（bifico）.Patients in group B were given bismuth quadruple therapy（clarithromycin,amoxicillin,rabeprazole and bismuth potassium citrate capsules）.Patients in group C were given standard triple therapy.Each course of treatment was 10 d.Adverse effects were observed during the treatment.Four weeks after the treatment,13C-UBT was re-performed to assess Hp eradication rate.Results A total of 139 patients completed the study.Hp eradication rates were 78.0％,76.0％,56.0％ by intention-to-treat（ITT） analysis and 81.3％,86.4％,59.6％ by per-protocol（PP） analysis in groups A,B and C,respectively.The eradication rates in group A and B were significantly higher than that in group C by both ITT and PP analysis （P ＜ 0.05）,but there was no significant difference between group A and group B.The incidence of side effects was significantly lower in group A than those in group B and group C （33.3％ vs 61.4％ and 55.3 ％,P ＜ 0.05）,but no significant difference was found between group B and group C（P ＞0.05）.The drug tolerance in group A was significantly higher than those in group B and group C （P ＜ 0.05）.Conclusion Both standard triple therapy combined with probiotic and bismuth quadruple therapy can greatly improve the Hp eradication rate,while probiotics can greatly reduce the incidence of adverse effect.

关 键 词：益生菌 幽门螺杆菌 慢性胃炎 

分 类 号：R573.3[医药卫生—消化系统]