酪酸梭菌联合四联疗法治疗Hp阳性胃溃疡疗效及对Hp根除率、血清炎症因子的影响
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摘要
目的研究酪酸梭菌联合四联疗法治疗Hp阳性溃疡疗效及对Hp根除率、血清炎症因子的影响。方法将某院2015年1月~2016年1月收治的122例Hp阳性胃溃疡患者纳为研究对象,考虑到脱落问题,将样本容量扩大20%,共选取146例患者作为研究对象,采用随机数字表法将其分为观察组(酪酸梭菌+四联疗法,n=73)与对照组(四联疗法,n=73),比较两组治疗效果、Hp根除率,检测两组血清炎症因子水平,随访6个月比较其溃疡复发率与Hp再感染率。结果观察组治疗期间有12例脱离研究,对照组脱落数也为12例,观察组、对照组参与完整研究的对象各61例;治疗后,观察组及对照组治疗有效率分别为83.61%和60.66%,差异有统计学意义(P<0.05);Hp根除率分别为85.26%和62.30%,差异有统计学意义(P<0.05);治疗结束后,观察组及对照组血清IL-6、IL-10、CRP水平均较治疗前显著下降,且观察组各指标下降幅度显著大于对照组,差异有统计学意义(P<0.05);6个月后溃疡复发率分别为3.28%和13.11%,Hp再感染率分别为9.84%和24.59%,差异有统计学意义(P<0.05)。结论酪酸梭菌联合四联疗法可有效提高Hp阳性溃疡治疗有效率与Hp根除率,改善血清炎症因子水平,减少溃疡复发率及Hp再感染率,值得临床推广。
OBJECTIVE To explore the efficacy of Clostridium butyricum combined with quadruple therapy on Hp-positive gastric ulcer and its effects on Hp eradication rate and serum inflammatory factors. METHODS 146 patients with Hp-positive gastric ulcer admitted to a hospital from January 2015 to January 2016 were selected. The patients were divided into the observation group( Clostridium butyricum and quadruple therapy,n= 73) and the control group( quadruple therapy,n= 73). The treatment effect and Hp eradication rate were observed in the two groups,and serum levels of inflammatory factors were measured,and the ulcer recurrence rate and Hp re-infection rate at 6 months of follow-up were compared. RESULTS There were 12 cases of shedding during treatment in the observation group,so as the control group. Each 61 cases participated in the complete study of the observation group and the control group. The treatment effective rate was 83. 61% in the observation group and 60. 66% in the control group( P < 0. 05),and the eradication rates of Hp were 85.26% and 62.30% respectively( P<0.05). After treatment,the levels of serum IL-6,IL-10 and CRP in the observation group were decreased significantly compared with those before treatment,and the decrease degree of each index in the observation group was significantly higher than that in the control group( P < 0. 05). The ulcer recurrence rates after 6 months were3.28% and 13. 11% respectively( P < 0. 05). The Hp re-infection rates were 9. 84% and 24. 59% respectively( P < 0. 05).CONCLUSION Clostridium butyricum combined with quadruple therapy can effectively improve the treatment effective rate of Hppositive ulcers and the Hp eradication rate,enhance the serum levels of inflammatory factors and reduce the ulcer recurrence rate and Hp re-infection rate,therefore it is worthy of clinical promotion.
OBJECTIVE To explore the efficacy of Clostridium butyricum combined with quadruple therapy on Hp-positive gastric ulcer and its effects on Hp eradication rate and serum inflammatory factors. METHODS 146 patients with Hp-positive gastric ulcer admitted to a hospital from January 2015 to January 2016 were selected. The patients were divided into the observation group( Clostridium butyricum and quadruple therapy,n= 73) and the control group( quadruple therapy,n= 73). The treatment effect and Hp eradication rate were observed in the two groups,and serum levels of inflammatory factors were measured,and the ulcer recurrence rate and Hp re-infection rate at 6 months of follow-up were compared. RESULTS There were 12 cases of shedding during treatment in the observation group,so as the control group. Each 61 cases participated in the complete study of the observation group and the control group. The treatment effective rate was 83. 61% in the observation group and 60. 66% in the control group( P < 0. 05),and the eradication rates of Hp were 85.26% and 62.30% respectively( P<0.05). After treatment,the levels of serum IL-6,IL-10 and CRP in the observation group were decreased significantly compared with those before treatment,and the decrease degree of each index in the observation group was significantly higher than that in the control group( P < 0. 05). The ulcer recurrence rates after 6 months were3.28% and 13. 11% respectively( P < 0. 05). The Hp re-infection rates were 9. 84% and 24. 59% respectively( P < 0. 05).CONCLUSION Clostridium butyricum combined with quadruple therapy can effectively improve the treatment effective rate of Hppositive ulcers and the Hp eradication rate,enhance the serum levels of inflammatory factors and reduce the ulcer recurrence rate and Hp re-infection rate,therefore it is worthy of clinical promotion.
引文
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[5]李桂水,杨敏京,边连朵,等.四联疗法联合口腔洁治对胃溃疡患者胃幽门螺杆菌根除的临床疗效观察[J].中国现代医学杂志,2016,26(5):140-142.
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[8]张冰,贾兰芳,王艳玲.布拉氏酵母菌散联合四联疗法根除幽门螺杆菌的疗效及对血清炎性因子水平的影响[J].中国地方病防治杂志,2017,32(2):220.
[2]陈建新.序贯治疗对消化性溃疡内镜表现及HP根除率的影响[J].山西职工医学院学报,2015,25(5):23-25.
[3]包英,杨元素,罗丹.健康体检成年人群幽门螺杆菌感染的相关因素研究[J].中国现代医学杂志,2016,26(12):127-130.
[4]王仲征,周雄杰.半夏泻心汤加味治疗HP阳性型消化道溃疡的临床疗效及对炎性因子、胃泌素的影响[J].中华中医药学刊,2017,35(6):1613-1616.
[5]李桂水,杨敏京,边连朵,等.四联疗法联合口腔洁治对胃溃疡患者胃幽门螺杆菌根除的临床疗效观察[J].中国现代医学杂志,2016,26(5):140-142.
[6]罗清甜,朱庆,谢俊锋,等.枯草杆菌二联活菌肠溶胶囊联合铋剂四联疗法治疗十二指肠球部溃疡的临床疗效[J].山东医药,2017,57(1):91-93.
[7]白芳芸,郑红英,冯雅宁,等.酪酸梭菌联合四联疗法治疗幽门螺杆菌阳性胃溃疡的作用机制研究[J].中国现代医学杂志,2017,27(9):83-86.
[8]张冰,贾兰芳,王艳玲.布拉氏酵母菌散联合四联疗法根除幽门螺杆菌的疗效及对血清炎性因子水平的影响[J].中国地方病防治杂志,2017,32(2):220.