酪酸梭菌联合四联疗法治疗胃溃疡对患者幽门螺杆菌根除率及促胃黏膜修复的效果  

Effect of Clostridium butyricum combined with quadruple therapy on Helicobacter pylori eradication rate and promoting gastric mucosal repair in patients with gastric ulcer

作　　者：胡圣丹 刘鹏 陶刘 HU Shengdan;LIU Peng;TAO Liu(Departments of Three Internal,Jianli Traditional Chinese Medicine Hospital,Jingzhou,Hubei,433300,China)

机构地区：[1]湖北省监利市中医医院内三科,湖北荆州433300

出　　处：《当代医学》2024年第15期74-78,共5页Contemporary Medicine

摘　　要：目的探讨酪酸梭菌(Cb)联合四联疗法治疗胃溃疡对患者幽门螺杆菌(Hp)根除率及促胃黏膜修复的效果。方法选取2021年11月至2023年5月湖北省监利市中医医院收治的胃溃疡患者104例作为研究对象,根据治疗方法分为对照组与观察组,每组52例。对照组给予四联疗法联合安慰剂治疗,观察组给予在四联疗法基础上联合Cb治疗。比较两组治疗前后溃疡周边黏膜组织胶原纤维沉积面积、羟脯氨酸含量、表皮生长因子(EGF)、血管内皮生长因子(VEGF)阳性表达率、肠道菌群水平、创面愈合疗效、Hp根除率和不良反应发生情况。结果观察组Hp根除率为86.54%,高于对照组的69.23%,差异有统计学意义(P<0.05)。观察组创面愈合总有效率为92.31%,高于对照组的76.92%,差异有统计学意义(P<0.05)。治疗后,两组胶原纤维沉积面积大于治疗前,羟脯氨酸含量高于治疗前,且观察组胶原纤维沉积面积大于对照组,羟脯氨酸含量高于对照组,差异有统计学意义(P<0.05)。治疗后,对照组肠杆菌、肠球菌、酵母菌水平高于治疗前,乳杆菌、双歧杆菌、双歧杆菌水平与肠杆菌比值低于治疗前,观察组乳杆菌、双歧杆菌水平及双歧杆菌与肠杆菌比值高于对照组,差异有统计学意义(P<0.05),观察组肠杆菌、肠球菌、酵母菌与治疗前比较差异无统计学意义;观察组乳杆菌、双歧杆菌、双歧杆菌与肠杆菌比值高于对照组,酵母菌低于对照组,差异有统计学意义(P<0.05);两组肠杆菌、肠球菌水平比较差异无统计学意义。治疗后,两组胃黏膜中VEGF、EGF阳性表达率均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组不良反应率比较差异无统计学意义。结论Cb联合四联疗法可提高胃溃疡患者Hp根除率,促进胃黏膜再生,调节肠道菌群,未明显增加不良反应,值得临床推广应用。Objective To investigate the effect of Clostridium casei(Cb)combined with quadruple therapy on Helicobacter pylori(Hp)eradication rate and promoting gastric mucosal repair in patients with gastric ulcer.Methods 104 cases of gastric ulcer patients admitted to theJianli Hospital of Traditional Chinese Medicine from November 2021 to May 2023 were selected as the study subjects,and they were divided into the control group and the observation group according to the different treatment method,with 52 cases in each group.The control group was given four-phase therapy combined with placebo treatment,and the observation group was given combined Cb treatment on the basis of four-phase therapy.The respect to the area of collagen fibre deposition in the mucosal tissue surrounding the ulcer,hydroxyproline content,epidermal growth factor(EGF),vascular endothelial growth factor(VEGF)positive expression rate,intestinal flora level,wound healing efficacy,Hp eradication rate and the occurrence of adverse reactions were compared before and after treatment between the two groups.Results The Hp eradication rate in the observation group was 86.54%,which was higher than 69.23%in the control group,and the difference was statistically significant(P<0.05).The total effective rate of wound healing in the observation group was 92.31%,which was higher than 76.92%in the control group,and the difference was statistically significant(P<0.05).After treatment,the area of collagen fibre deposition of the two groups were larger than that before treatment,and the level of hydroxyproline were higher than that before treatment,and the area of collagen fibre deposition in the observation group was larger than that in the control group,and the level of hydroxyproline was higher than that in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of Enterobacteriaceae,Enterococcus,and Yeast in the control group were higher than those before treatment,and the levels of Lactobacillus,Bifidobacterium,and Bifid

关 键 词：酪酸梭菌 四联疗法 胃溃疡 幽门螺杆菌 胃黏膜再生 

分 类 号：R573[医药卫生—消化系统]