摘要
目的探讨幽门螺杆菌(Hp)阳性胃溃疡合并2型糖尿病患者的抗Hp疗效特点,并观察益生菌辅助治疗的临床效果。方法前瞻性选取2019年5月至2020年8月武汉大学人民医院消化内科收治的86例Hp阳性胃溃疡合并2型糖尿病患者,按随机数字表法分为A组和B组各43例。另选取同期收治的50例Hp阳性胃溃疡不合并糖尿病患者,记为对照组。3组患者均接受标准四联抗Hp治疗,其中A组另给予益生菌辅助治疗。比较各组Hp根除率,同时重点观察A组、B组的溃疡愈合效果,检测肠道菌群和空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)水平。结果B组Hp根除率(67.44%)、溃疡总有效率(72.09%)均明显低于A组(86.05%、90.70%)、对照组(92.00%、94.00%),差异均有统计学意义(P<0.05),A组、对照组的Hp根除率、溃疡总有效率比较,差异均无统计学意义(P>0.05)。治疗后8周,A组乳酸杆菌、双歧杆菌数量为(7.85±0.64)、(8.83±0.68)lg cfu/g,明显高于B组[(7.35±0.75)、(7.57±0.65)lg cfu/g],肠杆菌、肠球菌数量为(7.13±0.43)、(6.02±0.72)lg cfu/g,明显低于B组[(7.50±0.45)、(6.38±0.76)lg cfu/g],差异均有统计学意义(P<0.05)。治疗后8周,A组FBG、2 h PBG、HbA1c水平分别为(6.90±0.53)mmol/L、(9.93±1.41)mmol/L、(6.94±0.39)%,均明显低于B组[(7.48±0.57)mmol/L、(11.04±1.62)mmol/L、(7.58±0.47)%],差异均有统计学意义(P<0.05)。结论Hp阳性胃溃疡合并2型糖尿病患者的抗Hp疗效不尽理想,Hp根除率明显较低,给予益生菌辅助治疗有助于调节患者肠道菌群数量和控制血糖水平,提高Hp根除率。
Objective To investigate the anti Hp efficacy of Helicobacter pylori(Hp)positive gastric ulcer patients with type 2 diabetes mellitus(T2DM),and to observe the clinical effect of probiotics adjuvant therapy.Methods A total of 86 patients with Hp-positive gastric ulcer and type 2 diabetes who were admitted to the Department of Gastroenterology,People's Hospital of Wuhan University were prospectively selected from May 2019 to August 2020,and were divided into group A and group B according to the rondom number table method,with 43 cases in each group.Another 50 cases of Hp positive gastric ulcer without diabetes were selected as control group.All patients in the three groups received standard quadruple anti Hp treatment,and group A was additionally given probiotics.The eradication rate of Hp in each group was compared,the ulcer healing effect of group A and group B was observed,and the levels of intestinal flora,fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG)and glycosylated hemoglobin A1c(HbA1c)were detected.Results Hp eradication rate(67.44%)and total effective rate of ulcer(72.09%)in group B were significantly lower than those in group A(86.05%,90.70%)and control group(92.00%,94.00%),and the differences were statistically significant(P<0.05),but there was no significant difference in Hp eradication rate and total effective rate of ulcer between group A and control group(P>0.05).Eight weeks after treatment,the numbers of lactobacilli and bifidobacteria in group A were(7.85±0.64)and(8.83±0.68)lg cfu/g,which were significantly higher than those in group B[(7.35±0.75),(7.57±0.65)lg cfu/g],the number of enterobacter and enterococcus were(7.13±0.43),(6.02±0.72)lg cfu/g,which were significantly lower than thsoe in group B[(7.50±0.45),(6.38±0.76)lg cfu/g],the differences were statistically significant(P<0.05).Eight weeks after treatment,the levels of FBG,2 h PBG,and HbA1c in group A were(6.90±0.53)mmol/L,(9.93±1.41)mmol/L,and(6.94±0.39)%,respectively,which were significantly lower than those
作者
吴娟
熊建光
程思
WU Juan;XIONG Jian-guang;CHENG Si(Department of Gastroenterology,People's Hospital of Wuhan University(Hubei Provincial People's Hospital),Wuhan Hubei 430000;Department of Gastroenterology,Xianning Central Hospital,Xianning Hubei 437000,China)
出处
《临床和实验医学杂志》
2021年第13期1419-1422,共4页
Journal of Clinical and Experimental Medicine
基金
湖北省自然科学基金项目(编号:2019-34)。
关键词
幽门螺杆菌
胃溃疡
2型糖尿病
HP
根除率
益生菌
血糖
肠道菌群
Helicobacter pylori
Gastric ulcer
Type 2 diabetes mellitus
Hp eradication rate
Probiotics
Blood glucose
Intestinal flora
