摘要
目的探讨不同疗程双歧杆菌四联活菌片辅助铋剂四联疗法在幽门螺杆菌(Helicobacter pylori, Hp)阳性胃溃疡患者初次根除治疗中对根除率、溃疡愈合率及不良反应的影响。方法选取2018年9月至2021年9月于开滦总医院消化内科门诊就诊患者219例进行前瞻性研究, 均为13C或14C-尿素呼气试验阳性且从未进行Hp根除治疗的胃溃疡患者, 利用Excel随机分组方法分为A、B、C组, A组为对照组(73例)给予14 d铋剂四联方案(艾普拉唑+果胶铋+阿莫西林+呋喃唑酮);B组(73例)在A组方案治疗第2周开始同时服用7 d双歧杆菌四联活菌片;C组(73例)在A组方案基础上同时服用14 d双歧杆菌四联活菌片。所有治疗结束后复查13C或14C-尿素呼气试验及胃镜, 比较3组在Hp根除、溃疡愈合及不良反应发生方面的差异。计量资料组间比较采用方差分析, 计数资料组间比较采用χ^(2)检验、Fisher精确概率法及分割χ^(2)检验。结果 3组根除率分别为90.8%(59/65)、91.2%(62/68)和91.0%(61/67), 差异无统计学意义(χ^(2)=0.01, P=0.997);3组溃疡愈合率分别为93.8%(61/65)、94.1%(64/68)和95.5%(64/67), B组与A组比较差异无统计学意义(P=1.000), C组与A组比较差异无统计学意义(P=0.716);3组不良反应发生率分别为21.4%(15/70)、7.1%(5/70)和7.0%(5/71), 差异有统计学意义(χ^(2)=9.21, P=0.010), 且B组、C组显著低于A组, 差异均有统计学意义(B组与A组比较:χ^(2)=5.83, P=0.016;C组与A组比较:χ^(2)=5.99, P=0.014)。结论 14 d及后半疗程7 d双歧杆菌四联活菌片辅助铋剂四联疗法在Hp阳性胃溃疡患者初次根除治疗中可以显著降低不良反应, 但双歧杆菌四联活菌片并不能显著提高Hp根除率, 且对胃溃疡愈合无促进作用。
Objective To explore the effects of different courses of Bifidobacterium combined with bismuth on the eradication rate,ulcer healing rate and adverse reactions in the initial eradication treatment of Helicobacter pylori positive gastric ulcer patients.Methods From September 2018 to September 2021,219 patients with gastric ulcer were selected from the outpatient department of gastroenterology department of Kailuan General Hospital Affiliated,all of whom were positive for 13C or 14C-urea breath test and were not treated with Helicobacter pylori eradication.Group A,B and C were randomly divided by Excel,Group A was the control group(73 patients):14-day bismuth quadruple therapy(Eprazole+colloidal bismuth pectin+amoxicillin+furazolidone);group B(73 patients):7 days Bifidobacterium tetravaccine tablets(live)was given in the second week of treatment in group A;group C(73 patients):Bifidobacterium tetravaccine tablets(live)was given 14 days on the basis of treatment in group A.13C or 14C-urea breath test and gastroscope were reexamined after all treatments,to compare the eradication rate,ulcer healing rate and the incidence of adverse reactions.Results The eradication rates in three groups were 90.8%(59/65),91.2%(62/68)and 91.0%(61/67)respectively,there was no significant difference among the three groups(χ^(2)=0.01,P=0.997).The ulcer healing rate in three groups were 93.8%(61/65),94.1%(64/68)and 95.5%(64/67)respectively,group B and group C were compared with group A,and the difference was not statistically significant(group B:group A P=1.000,group C:group A P=0.716).The incidence of adverse reactions in three groups was 21.4%(15/70),7.1%(5/70)and 7.0%(5/71)respectively,the difference was statistically significant(χ^(2)=9.21,P=0.010).The incidence of adverse reactions in group B and C was significantly lower than that in group A(group B:group Aχ^(2)=5.83,P=0.016;group C:groups Aχ^(2)=5.99,P=0.014).Compare means of measurement data among the three groups use analysis of variance.Chi square test,Fisher exact probabili
作者
汪海涛
夏建新
梅冬雪
段和力
Wang Haitao;Xia Jianxin;Mei Dongxue;Duan Heli(Departmentof Gastroenterology,Kailuan General Hospital,Tangshan 063000,China)
出处
《中国综合临床》
2022年第5期419-424,共6页
Clinical Medicine of China
基金
河北省医学科学研究课题计划(20191329)。
关键词
幽门螺杆菌
铋剂四联疗法
根除率
双歧杆菌
胃溃疡
Helicobacter pylori
Eradication rate
Bismuth quadruple therapy
Bifidobacterium
Gastric ulcer
