枯草杆菌二联活菌胶囊联合含艾普拉唑四联方案治疗根除幽门螺杆菌的效果  

Therapeutic effect of bacillus subtilis and enterococcus faecium enteric-coated capsules combined with ilaprazole containing quadruple regimen for remedial eradication of helicobacter pylori

作　　者：李雪梅 唐媛媛 邓燕红 丁晓玲[2] 呼圣娟[2] Li Xuemei;Tang Yuanyuan;Deng Yanhong;Ding Xiaoling;Hu Shengjuan(Department of Helicobacter Pylori Clinic,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750021,China)

机构地区：[1]宁夏回族自治区人民医院幽门螺杆菌专病门诊,银川750021 [2]宁夏回族自治区人民医院消化内科,银川750021

出　　处：《中国临床实用医学》2022年第5期70-74,共5页China Clinical Practical Medicine

基　　金：宁夏回族自治区重点研发计划重大(重点)项目(2019BFG02003)。

摘　　要：目的研究在含有艾普拉唑肠溶片的标准四联方案基础上加用枯草杆菌二联活菌胶囊在二次补救根除幽门螺杆菌(Hp)的临床效果,同时对比分析两者的药物相关不良反应差异。方法本研究为回顾性研究,选取2020年1月至2021年12月宁夏回族自治区人民医院幽门螺杆菌专病门诊及消化内科就诊经胃镜检查确定为慢性胃炎或消化性溃疡,且在首次根除Hp治疗后停用抗生素及铋剂4周、停用质子泵抑制剂(PPI)2周以上复查14C呼气试验或经胃镜病理检查证实幽门螺杆菌仍为阳性的600例患者,男265例,女335例,年龄(42.91±12.96)岁,年龄范围为18~80岁,进行补救性二次根除Hp治疗,根据是否加用益生菌将患者分为四联方案组(n=317)与益生菌组(n=283)。四联方案组予以含有艾普拉唑的标准四联方案根除Hp治疗,益生菌组在服药初期开始加用枯草杆菌二联活菌胶囊治疗,比较两组患者根除率和不良反应发生情况。结果益生菌组Hp意向性分析根除成功率[82.7%(234/283)]高于四联方案组[73.5%(233/317)],益生菌组Hp方案分析根除成功率[87.6%(234/267)]高于四联方案组[78.5%(233/297)],差异有统计学意义(P<0.05)。益生菌组患者不良反应发生率[(4.9%(13/267)]低于四联方案组[17.2%(51/297)],差异有统计学意义(P<0.05)。结论含艾普拉唑的标准四联疗法治疗幽门螺杆菌首次根除失败的患者有较好的根除率,同时联合益生菌治疗可进一步提高其二次根除成功率,可有效减轻患者药物不良反应,提高其依从性,值得临床推荐使用。Objective To study the clinical efficacy of live combined bacillus subtilis and enterococcus faecium enteric-coated capsules in the treatment of helicobacter pylori(Hp)eradication on the basis of standard quadruple regimen containing ilaprazole enteric coated tablet,and to compare the differences of drug-related adverse reactions.Methods This study was a retrospective study,a total of 600 patients diagnosed as chronic gastritis or peptic ulcer by gastroscopy were selected from the outpatient clinic and gastroenterology department of the People′s Hospital of Ningxia Hui Autonomous Region from January 2020 to December 2021 who stopped antibiotics and bismuth for 4 weeks and stopped proton pump inhibitors(PPI)for more than 2 weeks after the first Hp eradication treatment,14C breath test or gastroscopic pathological examination confirmed that Hp was still positive,265 males and 335 females,the age was(42.91±12.96)years old,ranging from 18 to 80 years old.Patients were divided into quadruple regimen group(n=317)and probiotic group(n=283)according to whether probiotics were added.The quadruple regimen group was treated with standard quadruple regimen containing eprazole for Hp eradication,while the probiotic group was treated with Bacillus subtilis combined with live bacteria capsules at the beginning of the treatment.The eradication rate and adverse reactions were compared between the two groups.Results The eradication success rate of Hp intent-to-treat analysis in probiotics group[82.7%(234/283)]was higher than that in quadruple regimen group[73.5%(233/317)],and the eradication success rate of Hp per-protocol analysis in probiotics group[87.6%(234/267)]was higher than that in quadruple regimen group[78.5%(233/297)],the differences were statistically significant(P<0.05).The incidence of adverse reactions in probiotics group[4.9%(13/267)]was lower than that in quadruple regimen group[17.2%(51/297)],and the difference was statistically significant(P<0.05).Conclusions The standard quadruple therapy containing ilaprazo

关 键 词：幽门螺杆菌 艾普拉唑 益生菌 根除率 不良反应 

分 类 号：R573[医药卫生—消化系统]