铋剂四联疗法联合双岐三联活菌对Hp感染患者的疗效
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摘要
为了对比分析2种含铋剂四联疗法联合双岐三联活菌胶囊分别对幽门螺杆菌(Helicobacter pylori,Hp)感染患者疗效的影响。本研究随机选取200例就诊的Hp感染患者,将患者随机分为4组,每组50例。A组(埃索美拉唑,克拉霉素,阿莫西林,枸橼酸铋钾胶囊)、B组(埃索美拉唑,呋喃唑酮,阿莫西林,枸橼酸铋钾胶囊)、C组(埃索美拉唑,克拉霉素,阿莫西林,枸橼酸铋钾胶囊,双歧杆菌三联活菌胶囊)和D组(埃索美拉唑,呋喃唑酮,阿莫西林,枸橼酸铋钾胶囊和双歧杆菌三联活菌胶囊)。分析对比四组患者的临床缓解疗效、幽门螺旋杆菌根除效率、不良反应、复发情况及成本效果比。研究表明:2种含铋剂四联疗法联合双岐三联活菌胶囊对幽门螺杆菌感染患者的临床缓解症状、幽门螺杆菌根除率效果、不良反应发生率和复发情况效果优于含铋剂四联疗法,但是D组成本效果比更具有经济学优势。埃索美拉唑、呋喃唑酮、阿莫西林、枸橼酸铋钾胶囊和双歧杆菌三联活菌胶囊联合可促进Hp患者恢复,根除率高,降低不良反应和复发率,且具有经济学优势,值得推广应用。
To compare and analyze the effects of two bismuth-containing quadruple therapies combined with Bifid Triple Viable capsules on the efficacy of Helicobacter pylori(Hp) patients. 200 patients with HP infection were randomly selected and randomly divided into four groups with 50 cases in each group. Group A(Esomeprazole,Clarithromycin, Amoxicillin, Bismuth Potassium Citrate Capsules), Group B(Esomeprazole, Furazolidone, Amoxicillin, Bismuth Potassium Citrate Capsules), Group C(Esomeprazole, Clarithromycin, Amoxicillin, Bifidobacterium Bifidum Capsules) and Group D(Esomeprazole, Furazolidone, Amoxicillin, Bismuth Potassium Citrate Capsules and Bismuth Potassium Citrate Capsules), and Group D(Esomeprazole, Furazolidone, Bism Bifidobacterium triple viable capsule. The clinical remission effect, eradication efficiency of Hp, adverse reactions, recurrence and cost-effectiveness ratio of the four groups were analyzed and compared. Two bismuth-containing quadruple therapies combined with Bifid Triple Viable capsules were better than bismuth-containing quadruple therapies in alleviating clinical symptoms, eradication rat e of Helicobacter pylori, incidence of adverse reactions and recurrence in patients with Helicobacter pylori infection, but the cost-effectiveness of group D was better than that of bifide-containing quadruple therapies. Esomeprazole, furazolidone, amoxicillin, bismuth potassium citrate capsules and Bifidobacterium triple viable capsules can promote the recovery of patients with Hp, with high eradication rate, and reduce adverse reactions and recurrence rate. It has economic advantages and is worth popularizing and applying.
To compare and analyze the effects of two bismuth-containing quadruple therapies combined with Bifid Triple Viable capsules on the efficacy of Helicobacter pylori(Hp) patients. 200 patients with HP infection were randomly selected and randomly divided into four groups with 50 cases in each group. Group A(Esomeprazole,Clarithromycin, Amoxicillin, Bismuth Potassium Citrate Capsules), Group B(Esomeprazole, Furazolidone, Amoxicillin, Bismuth Potassium Citrate Capsules), Group C(Esomeprazole, Clarithromycin, Amoxicillin, Bifidobacterium Bifidum Capsules) and Group D(Esomeprazole, Furazolidone, Amoxicillin, Bismuth Potassium Citrate Capsules and Bismuth Potassium Citrate Capsules), and Group D(Esomeprazole, Furazolidone, Bism Bifidobacterium triple viable capsule. The clinical remission effect, eradication efficiency of Hp, adverse reactions, recurrence and cost-effectiveness ratio of the four groups were analyzed and compared. Two bismuth-containing quadruple therapies combined with Bifid Triple Viable capsules were better than bismuth-containing quadruple therapies in alleviating clinical symptoms, eradication rat e of Helicobacter pylori, incidence of adverse reactions and recurrence in patients with Helicobacter pylori infection, but the cost-effectiveness of group D was better than that of bifide-containing quadruple therapies. Esomeprazole, furazolidone, amoxicillin, bismuth potassium citrate capsules and Bifidobacterium triple viable capsules can promote the recovery of patients with Hp, with high eradication rate, and reduce adverse reactions and recurrence rate. It has economic advantages and is worth popularizing and applying.
引文
Boltin D.,Dotan I.,and Birkenfeld S.,2019,Improvement in the implementation of Helicobacter pylori management guidelines among primary care physicians following a targeted educational intervention,Ann.Gastroenterol.,32(1):52-59
Zhang D.,Ke L.,Nie A.Y.,Liang L.J.,and Shi Y.Q.,2017,Efficacy and safety of berberine-containing quadruple regimen as rescue therapy for Helicobacter pylori eradication,Xiandai Shengwu Yixue Jingzhan(Progress in Modern Biomedicine),17(3):464-469(张迪,柯丽,聂爱英,梁丽娟,时永全,2017,黄连素四联方案补救治疗幽门螺杆菌感染的有效性和安全性,现代生物医学进展,17(3):464-469)
Zhang B.,Zeng B.Z.,Zhang B.,Zhang Q.,and Lv X.Y.,2017,Expression of p53 and p21WAF1 proteins in gastric carcinoma and their relationship with Helicobacter pylori L-type infection,Xiandai Shengwu Yixue Jingzhan(Progress in Mod-ern Biomedicine)17(28):5569-5573(张波,曾帮智,张博,张茜,吕晓玥,2017,胃癌组织中p53、p21WAF1蛋白的表达及与幽门螺杆菌L型感染的关系研究,现代生物医学进展,17(28):5569-5573)
Lim H.,Bang C.S.,Shin W.G.,Choi J.H.,Soh J.S.,Kang H.S.,Yang Y.J.,Hong J.T.,Shin S.P.,Suk K.T.,Lee J.J.,Baik G.H.,and Kim D.J.,2018,Modified quadruple therapy versus bismuth-containing quadruple therapy in first-line treatment of Helicobacter pylori infection in Korea;rationale and design of an open-label,multicenter,randomized controlled trial,Medicine,97(46):e13245
Chen L.,Xu W.,Lee A.,He J.M.,Huang B.X.,Zheng W.F.,Su T.T.,Lai S.C.,Long Y.Q.,Chu H.,Chen Y.J.,Wang L.,Wang K.,Si J.M.,and Chen S.J.,2018,The impact of Helicobacter pylori infection,eradication therapy and probiotic supplementation on gut microenvironment homeostasis:An open-label,randomized clinical trial,EBioMedicine,35:87-96
Kwon S.,Lee D.H.,Kang J.B.,Kim N.,Park Y.S.,Shin C.M.,Yoon H.,and Choi Y.J.,2018,The efficacy of bismuthcontaining quadruple therapy after moxifloxacin-based sequential therapy failure in Helicobacter pylori eradication,Korean.J.Gastroenterol.,71(4):196-203
Liu L.,Cheng G.X.,Wu Z.H.,Xu Z.Q.,and Yang Y.H.,2017,Influence of Helicobacter pylori eradication therapy on motor symptoms in patients with parkinson's disease,Xiandai Shengwu Yixue Jingzhan(Progress in Modern Biomedicine)17(5):862-865(刘磊,程国雄,吴卓华,徐振球,杨应浩,2017,幽门螺杆菌根除治疗对帕金森病患者运动症状的影响,现代生物医学进展,17(5):862-865)
Liu L.L.,Ying D.L.,and Zhang H.Z.,2018,Effect of Jinghua Weikang capsules combined with quadruple therapy on Helicobacter pylori infection,Zhongguo Xiandai Yixue Zazhi(China Journal of Modern Medicine),28(22):117-121(刘玲玲,营大礼,张会珍,2018,荆花胃康胶丸联合四联疗法在幽门螺杆菌感染患者中的应用效果,中国现代医学杂志,28(22):117-121)
Ierardi E.,Giorgio F.,Iannone A.,Losurdo G.,Principi M.,Barone M.,Pisani A.,and Di Leo A.,2017,Noninvasive molecular analysis of Helicobacter pylori:is it time for tailored first-line therapy?World J.Gastroenterol.,23(14):2453-2458
Dore M.P.,Soro S.,Rocchi C.,Loria M.F.,BibbòS.,and Pes G.M.,2016,Inclusion of lactobacillus reuteri in the treatment of Helicobacter pylori in sardinian patients:a case report series,Medicine,95(15):e3411
Zhang D.,Ke L.,Nie A.Y.,Liang L.J.,and Shi Y.Q.,2017,Efficacy and safety of berberine-containing quadruple regimen as rescue therapy for Helicobacter pylori eradication,Xiandai Shengwu Yixue Jingzhan(Progress in Modern Biomedicine),17(3):464-469(张迪,柯丽,聂爱英,梁丽娟,时永全,2017,黄连素四联方案补救治疗幽门螺杆菌感染的有效性和安全性,现代生物医学进展,17(3):464-469)
Zhang B.,Zeng B.Z.,Zhang B.,Zhang Q.,and Lv X.Y.,2017,Expression of p53 and p21WAF1 proteins in gastric carcinoma and their relationship with Helicobacter pylori L-type infection,Xiandai Shengwu Yixue Jingzhan(Progress in Mod-ern Biomedicine)17(28):5569-5573(张波,曾帮智,张博,张茜,吕晓玥,2017,胃癌组织中p53、p21WAF1蛋白的表达及与幽门螺杆菌L型感染的关系研究,现代生物医学进展,17(28):5569-5573)
Lim H.,Bang C.S.,Shin W.G.,Choi J.H.,Soh J.S.,Kang H.S.,Yang Y.J.,Hong J.T.,Shin S.P.,Suk K.T.,Lee J.J.,Baik G.H.,and Kim D.J.,2018,Modified quadruple therapy versus bismuth-containing quadruple therapy in first-line treatment of Helicobacter pylori infection in Korea;rationale and design of an open-label,multicenter,randomized controlled trial,Medicine,97(46):e13245
Chen L.,Xu W.,Lee A.,He J.M.,Huang B.X.,Zheng W.F.,Su T.T.,Lai S.C.,Long Y.Q.,Chu H.,Chen Y.J.,Wang L.,Wang K.,Si J.M.,and Chen S.J.,2018,The impact of Helicobacter pylori infection,eradication therapy and probiotic supplementation on gut microenvironment homeostasis:An open-label,randomized clinical trial,EBioMedicine,35:87-96
Kwon S.,Lee D.H.,Kang J.B.,Kim N.,Park Y.S.,Shin C.M.,Yoon H.,and Choi Y.J.,2018,The efficacy of bismuthcontaining quadruple therapy after moxifloxacin-based sequential therapy failure in Helicobacter pylori eradication,Korean.J.Gastroenterol.,71(4):196-203
Liu L.,Cheng G.X.,Wu Z.H.,Xu Z.Q.,and Yang Y.H.,2017,Influence of Helicobacter pylori eradication therapy on motor symptoms in patients with parkinson's disease,Xiandai Shengwu Yixue Jingzhan(Progress in Modern Biomedicine)17(5):862-865(刘磊,程国雄,吴卓华,徐振球,杨应浩,2017,幽门螺杆菌根除治疗对帕金森病患者运动症状的影响,现代生物医学进展,17(5):862-865)
Liu L.L.,Ying D.L.,and Zhang H.Z.,2018,Effect of Jinghua Weikang capsules combined with quadruple therapy on Helicobacter pylori infection,Zhongguo Xiandai Yixue Zazhi(China Journal of Modern Medicine),28(22):117-121(刘玲玲,营大礼,张会珍,2018,荆花胃康胶丸联合四联疗法在幽门螺杆菌感染患者中的应用效果,中国现代医学杂志,28(22):117-121)
Ierardi E.,Giorgio F.,Iannone A.,Losurdo G.,Principi M.,Barone M.,Pisani A.,and Di Leo A.,2017,Noninvasive molecular analysis of Helicobacter pylori:is it time for tailored first-line therapy?World J.Gastroenterol.,23(14):2453-2458
Dore M.P.,Soro S.,Rocchi C.,Loria M.F.,BibbòS.,and Pes G.M.,2016,Inclusion of lactobacillus reuteri in the treatment of Helicobacter pylori in sardinian patients:a case report series,Medicine,95(15):e3411