亿活联合标准三联疗法根除幽门螺杆菌的临床疗效  

Efficacy of Saccharomyces boulardii as adjuvant to triple therapy in eradication of Helicobacter pylori

作　　者：邓蓉[1] 霍丽娟[2] 张婕[2] 李亚芳[1] 

机构地区：[1]山西医科大学,山西太原030001 [2]山西医科大学第一医院消化科,山西太原030001

出　　处：《中国微生态学杂志》2016年第6期695-699,共5页Chinese Journal of Microecology

摘　　要：目的探讨布拉氏酵母菌散(亿活)联合标准三联疗法根除幽门螺杆菌(Helicobacter pylori)的疗效。方法收集内镜下行快速尿素酶试验及14 C呼气试验(14 C-UBT)均为阳性的慢性非萎缩性胃炎患者200例。随机分为四组(各50例):A组给予标准三联疗法(埃索美拉唑肠溶片20mg Bid+阿莫西林1.0g Bid+呋喃唑酮0.1g Bid)7d;B组先给予标准三联疗法7d,再口服亿活(0.5g Bid)14d;C组先口服亿活14d,再给予标准三联疗法7d;D组同时给予标准三联疗法及亿活7d,再继续口服亿活7d。各组患者均疗程结束后4周复查14 C-UBT。正态分布的计量资料行t检验,计数资料采用卡方检验进行比较。结果共185例患者完成随访。B、C、D组患者H.pylori根除率及临床症状缓解率均高于A组,其不良反应发生率均低于A组,B、C组患者具有相同的临床疗效,D组患者幽门螺杆菌的根除率及临床症状缓解率均高于B、C组,其不良反应发生率均低于B、C组,但B、C、D三组患者间差异无统计学意义。结论亿活不同方式联合标准三联疗法可提高慢性非萎缩性胃炎患者H.pylori的根除率,其中亿活与标准三联同时服用(D组)既可以快速重建胃肠道微生态环境,同时可以抑制幽门螺杆菌的生长,总疗程比B、C组短,患者依从性好,因此最具有临床价值。Objective To evaluate the efficacy of Saccharomyces boulardii as the adjuvant to standard triple therapy in the eradication of Helicobacter pylori.Methods A total of 200 patients with positive H.pylori infection by endoscopy rapid urease testing and ^14 C-UBT were randomly divided into four groups：Group A（triple therapy of Esomeprazole 20 mg bid ＋ Amoxicillin 1.0g bid ＋furaxone 0.1g bid for seven days）,Group B（seven days of triple therapy followed by 14 days of S.boulardii）,Group C（fourteen days of S.boulardii followed by seven days of triple therapy）or Group D（S.boulardii ＋ triple therapy for seven days followed by another 7days of S.boulardii）.Four weeks after the treatment the patients were reexamined for H.pylori by using ^14 C-UBT.The t test was performed on normally distributed measurement data,and Chi square test was performed on count data;the results were compared.Results 185 patients completed the follow-up.The eradication rates and the clinical symptom remission rates of group B,C and D were higher than those of group A（Ps〈0.05）,while the adverse effect rates were lower than that of group A（Ps〈0.05）.Similar clinical effects were seen in groups B and C.The eradication rate and clinical symptom remission rate of group D were higher than those of groups B and C,while the adverse effect rate of group D was lower than those of group B and C,with insignificant differences among groups B,C and D（Ps〉0.05）.Conclusion S.boulardii as an adjuvant to standard triple therapy in different ways in treatment of Helicobacter pylori infection can improve the rate of Helicobacter pylori eradication and symptom remission while reduce adverse events.Particularly,simultaneous administration of S.boulardii and standard triple therapy has more clinical value,because the scheme can rebuild gastrointestinal tract microecological balance rapidly while inhibit the growth of H.pylori.

关 键 词：幽门螺杆菌 根除率 亿活 布拉酵母 标准三联疗法 

分 类 号：R573.3[医药卫生—消化系统]