布拉酵母菌根除老年幽门螺杆菌感染患者临床观察
摘要
目的对比分析标准三联疗法、布拉酵母菌联合标准三联疗法、布拉酵母菌及荆花胃康联合标准三联疗法对于老年患心脑血管疾病需长期服用阿司匹林等非甾体抗炎药物(NSAIDs)、检测幽门螺杆菌(H. pylori)阳性患者的临床疗效。方法 150例需长期服用阿司匹林且伴有H. pylori阳性老年患者,随机分为标准三联组(A组)、布拉酵母菌联合三联组(B组)、布拉酵母菌及荆花胃康联合三联组(C组),每组各50例。其中A组给予(雷贝拉唑钠肠溶片,10 mg,2次/d+阿莫西林分散片,1 000 mg,2次/d+克拉霉素分散片,500 mg,2次/d),B组在A组的基础上加布拉酵母菌散(布拉酵母菌散,1袋,2次/d),C组在B组基础上加荆花胃康胶丸(荆花胃康胶丸,2粒,3次/d),各组疗程均为14 d。对比各组治疗结束4 w后的H. pylori根除情况及消化不良症状(腹痛、腹胀、早饱及嗳气)缓解情况;对比各组治疗期间药物不良反应发生情况。结果A、B、C组H. pylori根除率分别为56%、76%、80%,A组与B组、A组与C组比较差异均有统计学意义(P<0. 05),而B组与C组比较差异无统计学意义(P>0. 05); A、B、C组消化不良症状(腹痛、腹胀、早饱及嗳气)缓解率分别为46%、60%、76%,三组比较差异有统计学意义(P<0. 05);各组治疗期间不良反应发生率相比,A组52%、B组30%、C组26%,各组比较差异有统计学意义(P<0. 05)。结论布拉酵母菌及荆花胃康联合标准三联疗法不仅在根除H. pylori、改善患者症状方面疗效显著,尤其可显著降低药物不良反应发生率(特别是抗生素相关性腹泻),老年患者更易耐受。
引文
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11胡伏莲,周殿元.幽门螺杆菌感染的基础与临床[M].第3版.北京:中国科技出版社,2009:635-44.
12 Senol A,Karahan AG.Effect of probiotics on a spirin-induced gastric mucosal lesions[J].Turk J Gastroenterol,2011;22(1):18-26.
13刘鹏鸿,霍丽娟.益生菌联合三联疗法根除幽门螺杆菌的Meta分析[J].中华实验和临床感染病杂志(电子版),2014;8(3):379-83.
14 Szajewska H,Horvath A,Piwowarczyk A.Meta-analysis:the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment[J].Aliment Pharmacol Therapeut,2010;32(9):1069-79.
15 Lee JS,Paek NS,Kwon NS,et al.Anti-inflammatory action of probiotics through activating suppressor of cytokine signaling(SOCS)expression and signaling in Helicobacter pylori infection:a novel mechanism[J].Gastroenterol Hepatol,2010;25(7):194-202.
16 Malfertheiner P,Megraud F,O'Morain CA,et al.Management of Helicobacter pylori infection:the MaastrichtⅣ/florence consensus report[J].Gut,2012;61(5):646-64.
17何永红,陈伟峰,刘霞,等.序贯疗法与标准四联疗法对幽门螺杆菌根除失败后补救治疗的疗效分析[J].胃肠病学,2012;17(8):477-9.
2抗血小板药物消化道损伤的预防和治疗中国专家共识组.抗血小板药物消化道损伤的预防和治疗中国专家共识[J].中华内科杂志,2013;52(3):264-70.
3 Laine L,Jensen DM.Management of patients with ulcer bleeding[J].Am J Gastroenterol,2012;107(3):345-60.
4中华医学会消化病学分会幽门螺杆菌学组/全国幽门螺杆菌研究协作组.第四次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2012;51(10):832-7.
5 Song Z,Zhou L,Wang Y,et al.A study to explore Hp antibiotic resistance and efficacy of eradication therapy in China(multi-center,nationwide,randomized,control study)[J].Helicobacter,2011;16(1):117-8.
6 Sun QJ,Liang X,Zheng Q,et al.Resistance of Helicobacter pylori to antibiotics from 2000 to 2009 in Shanghai[J].World J Gastroenterol,2010;16(40):5118-21.
7中华医学会消化病学分会幽门螺杆菌学组/全国幽门螺杆菌科研协作组,成虹,胡伏莲,等.中国幽门螺杆菌耐药状况以及耐药对治疗的影响---全国多中心临床研究[J].胃肠病学,2007;12(9):525-30.
8 Tong JL,Ran ZH,Shen J,et al.Meta-analysis:the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy[J].Aliment Pharmacol Ther,2007;25(2):155-68.
9 Ye H,Liu Y,Li N,et al.Anti-Helicobacter pylori activities of Chenopodium ambrosioides L.in vitro and in vivo[J].World J Gastroenterol,2015;21(14):4178-83.
10 Asad ID,Adnan MAH,Ding HY,et al.Do probiotics improve eradication response to Helicobacter pylori on standard triple or sequential therapy[J].The Saudi J Gastroenterol,2013;19(10):113-20.
11胡伏莲,周殿元.幽门螺杆菌感染的基础与临床[M].第3版.北京:中国科技出版社,2009:635-44.
12 Senol A,Karahan AG.Effect of probiotics on a spirin-induced gastric mucosal lesions[J].Turk J Gastroenterol,2011;22(1):18-26.
13刘鹏鸿,霍丽娟.益生菌联合三联疗法根除幽门螺杆菌的Meta分析[J].中华实验和临床感染病杂志(电子版),2014;8(3):379-83.
14 Szajewska H,Horvath A,Piwowarczyk A.Meta-analysis:the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment[J].Aliment Pharmacol Therapeut,2010;32(9):1069-79.
15 Lee JS,Paek NS,Kwon NS,et al.Anti-inflammatory action of probiotics through activating suppressor of cytokine signaling(SOCS)expression and signaling in Helicobacter pylori infection:a novel mechanism[J].Gastroenterol Hepatol,2010;25(7):194-202.
16 Malfertheiner P,Megraud F,O'Morain CA,et al.Management of Helicobacter pylori infection:the MaastrichtⅣ/florence consensus report[J].Gut,2012;61(5):646-64.
17何永红,陈伟峰,刘霞,等.序贯疗法与标准四联疗法对幽门螺杆菌根除失败后补救治疗的疗效分析[J].胃肠病学,2012;17(8):477-9.