双歧杆菌四联活菌片联合四联疗法治疗儿童Hp阳性消化性溃疡的起效机制研究  

Study on the mechanism of action of bifidobacterium quadruple active tablets combinedwith quadruple therapy in the treatment of Hp positive peptic ulcers in children

作　　者：何丽丹 王红[2] 蔡振荡 陈福将 HE Lidan;WANG Hong;CAI Zhendang;CHEN Fujiang(Department of Pediatrics,Wenzhou Integrated Traditional Chinese and Western Medicine Hospital,Wenzhou,Zhejiang 325000,China;不详)

机构地区：[1]温州市中西医结合医院儿科,浙江温州325000 [2]宁波市妇女儿童医院小儿消化科,浙江宁波315012

出　　处：《中华全科医学》2025年第5期802-805,共4页Chinese Journal of General Practice

基　　金：浙江省卫生健康科技计划项目(2021KY1059)。

摘　　要：目的 为提高儿童幽门螺杆菌(Hp)阳性消化性溃疡(PU)的疗效水平,分别从对于肠道免疫功能和细胞因子的影响方面探讨双歧杆菌四联活菌片联合四联疗法的临床疗效和起效机制。方法 纳入2021年12月—2024年1月温州市中西医结合医院收治的160例Hp阳性消化性溃疡患儿,采用随机数字表法分为对照组(80例)和研究组(80例)。对照组予以四联疗法(包括2种抗生素、质子泵抑制剂、铋剂),研究组在四联疗法基础上增加双歧杆菌四联活菌片治疗。评价消化性溃疡疗效水平,检测治疗前后血清胃蛋白酶(PG)、胃泌素(GAS)、细胞因子含量,分析辅助性T细胞17(Th17)/调节性T细胞(Treg)免疫平衡状态,统计Hp转阴及治疗后6个月消化性溃疡复发情况,观察治疗期间药物不良反应。结果 研究组治疗总体有效率(93.75%,75/80)高于对照组(81.25%,65/80),差异有统计学意义(P<0.05)。治疗2周后,研究组血清PGⅠ、PGⅡ和GAS均低于对照组(P<0.001);研究组血清Th17、Treg、Th17/Treg、白细胞介素17(IL-17)和转化生长因子β(TGF-β)均低于对照组(P<0.001)。研究组治疗后Hp转阴率(88.75%,71/80)高于对照组(73.75%,59/80),而治疗后6个月消化性溃疡复发率(8.75%,7/80)低于对照组(22.50%,18/80),差异均有统计学意义(P<0.05)。2组治疗期间药物不良反应发生率比较差异无统计学意义(P>0.05)。结论 双歧杆菌四联活菌片联合四联疗法治疗儿童Hp阳性PU,可降低胃蛋白酶、胃泌素分泌水平,提高肠道免疫功能并抑制炎症反应,进而增强PU临床疗效水平,促进Hp转阴,预防PU复发。Objective To improve the therapeutic efficacy of Helicobacter pylori(Hp)-positive peptic ulcer(PU)in children,this study investigates the clinical outcomes and mechanistic effects of combining Bifidobacterium quadruple viable tablets with quadruple therapy,focusing on their impacts on intestinal immune function and cytokine levels.Methods A total of 160 children with Hp positive peptic ulcers admitted to Wenzhou Integrated Traditional Chinese and Western Medicine Hospital from December 2021 to January 2024 were included and randomly divided into a control group(80 cases)and an observation group(80 cases).The control group received quadruple therapy(including two kinds of antibiotics,a proton pump inhibitor,and a bismuth agent),while the observation group received treatment with Bifidobacterium quadruple live bacterial tablets in addition to quadruple therapy.The therapeutic effect level of peptic ulcers was evaluated.The levels of serum pepsinogen(PG),gastrin(GAS),and cytokines were measured before and after treatment.The T-helper 17(Th17)/regulatory T cells(Treg)immune balance status were analyzed.The Hp conversion to negative and recurrence of peptic ulcers 6 months after treatment were statistical analysis.The adverse drug reactions were observed.Results The overall effective rate of treatment in observation group(93.75%,75/80)was higher than control group(81.25%,65/80,P<0.001).After 2 weeks of treatment,the serum levels of PGⅠ,PGⅡ,GAS in the observation group were lower than those of control group(P<0.001),and the contents of serum Th17,Treg,Th17/Treg,IL-17,and TGF in the observation group were lower than control group(P<0.001).The Hp seroconversion rate in the observation group after treatment(88.75%,71/80)was significantly higher than that in the control group(73.75%,59/80),while the recurrence rate of peptic ulcers at 6 months after treatment(8.75%,7/80)was significantly lower than that in the control group(22.50%,18/80,P<0.001).The difference in the incidence of adverse drug reactions between the two

关 键 词：双歧杆菌四联活菌片 幽门螺杆菌 消化性溃疡 免疫功能 炎症反应 

分 类 号：R725.7[医药卫生—儿科]