四联疗法联合益生菌治疗幽门螺杆菌阳性糜烂性胃炎疗效观察  

Efficacy of quadruple therapy combined with probiotics for helicobacter pylori-positive erosive gastritis

作　　者：张伟 Zhang Wei(Department of Gastroenterology,Jinan Seventh People's Hospital,Jinan 250000,Shandong Province,China)

机构地区：[1]济南市第七人民医院消化内科,济南250000

出　　处：《中国基层医药》2022年第5期641-645,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察四联疗法联合益生菌治疗幽门螺杆菌阳性糜烂性胃炎患者的临床疗效。方法选取济南市第七人民医院2020年1月至2021年1月收治的幽门螺杆菌阳性糜烂性胃炎患者350例,采用随机数字表法分为对照组(n=175)、观察组(n=175)。对照组采用四联疗法(克拉霉素、瑞巴派特、阿莫西林、雷贝拉唑)治疗,观察组采用四联疗法联合益生菌治疗,两组疗程2周。比较两组临床疗效。结果观察组总有效率为90.86%(150/175),显著高于对照组的72.57%(127/175),差异有统计学意义(χ^(2)=19.58,P<0.001)。治疗后,两组胃肠道微生态指标均改善,观察组均优于对照组(t=15.14、14.30、17.37,均P<0.001)。治疗后3个月、6个月,观察组幽门螺杆菌转阴率分别为72.57%(127/175)、95.43%(167/175),均高于对照组的50.29%(88/175)、79.43%(139/175),差异均有统计学意义(χ^(2)=18.34、20.38,均P<0.001)。治疗后,观察组血清胃泌素、胃动素、肿瘤坏死因子α、白细胞介素6改善情况均优于对照组(t=35.15、44.91、16.76、5.73,均P<0.001)。结论四联疗法联合益生菌治疗幽门螺杆菌阳性糜烂性胃炎临床疗效显著,可提高幽门螺杆菌转阴率,有助于患者胃肠道功能的改善,有效抑制炎性反应。Objective To investigate the clinical efficacy of quadruple therapy combined with probiotics for helicobacter pylori-positive erosive gastritis.Methods A total of 350 patients with helicobacter pylori-positive erosive gastritis who received treatment in Jinan Seventh People's Hospital from January 2020 to January 2021 were included in this study.They were randomly assigned to receive a quadruple therapy(clarithromycin,ribavirin,amoxicillin and rabeprazole)alone(control group,n=175)or in combination with probiotics(observation group,n=175)for 2 weeks.Clinical efficacy was compared between the two groups.Results Total response rate was 90.86%(150/175)in the observation group,which was significantly higher than that in the control group[72.57%(127/175),χ^(2)=19.58,P<0.001].After treatment,gastrointestinal microbiota were improved in both groups,but the improvements were greater in the observation group than in the control group(t=15.14,14.30,17.37,all P<0.001).At 3 and 6 months after treatment,conversion rates from helicobacter pylori-positive to helicobacter pylori-negative in the observation group were 72.57%(127/175)and 95.43%(167/175)respectively,which were significantly higher than 50.29%(88/175)and 79.43%(139/175)in the control group(χ^(2)=18.34,20.38,both P<0.001).After treatment,the amplitude of decrease in serum level of gastrin,motilin,tumor necrosis factor-αand interleukin-6 in the observation group were greater than those in the control group(t=35.15,44.91,16.76,5.73,all P<0.001).Conclusion Quadruple therapy combined with probiotics is highly effective on helicobacter pylori-positive erosive gastritis.The combined therapy can increase conversion rate from helicobacter pylori-positive to helicobacter pylori-negative,improve gastrointestinal function,and greatly inhibit inflammatory reaction.

关 键 词：胃炎 幽门螺杆菌 多种药物疗法 有益菌种 胃泌素类 促胃动素 肿瘤坏死因子α 白细胞介素6 

分 类 号：R573.3[医药卫生—消化系统]