Helicobacter pylori(H. pylori) plays a role in the patho-genesis of gastric cancer. The outcome of the infection depends on environmental factors and bacterial and host characteristics. Gastric carcinogenesis is a mul...Helicobacter pylori(H. pylori) plays a role in the patho-genesis of gastric cancer. The outcome of the infection depends on environmental factors and bacterial and host characteristics. Gastric carcinogenesis is a multistep process that is reversible in the early phase of mucosal damage, but the exact point of no return has not been identified. Therefore, two main therapeutic strategies could reduce gastric cancer incidence:(1) eradication of the already present infection; and(2) immunization(prior to or during the course of the infection). The success of a gastric cancer prevention strategy depends on timing because the prevention strategy must be introduced before the point of no return in gastric carcinogenesis. Although the exact point of no return has not been identified, infection should be eradicated before severe atrophy of the gastric mucosa develops. Eradication therapy rates remain suboptimal due to increasing H. pylori resistance to antibiotics and patient noncompliance. Vaccination against H. pylori would reduce the cost of eradication therapies and lower gastric cancer incidence. A vaccine against H. pylori is still a research challenge. An effective vaccine should have an adequate route of delivery, appropriate bacterial antigens and effective and safe adjuvants. Future research should focus on the development of rescue eradication therapy protocols until an efficacious vaccine against the bacterium becomes available.展开更多
OBJECTIVE： To determine the effectiveness of modified Sanhuang Xiexin Tang （SHXXT） plus additional herbs （MSAH） combined with ＂standard tri- ple therapy＂ for eradication of Helicobacter pylori （H. pylori） and...OBJECTIVE： To determine the effectiveness of modified Sanhuang Xiexin Tang （SHXXT） plus additional herbs （MSAH） combined with ＂standard tri- ple therapy＂ for eradication of Helicobacter pylori （H. pylori） and amelioration of related symptoms in comparison with standard triple and standard quadruple therapies. METHODS： From October 2015 to May 2016, we recruited patients with dyspepsia symptoms con- firmed to have H. pylori infection by the ^13C urea breath test in our outpatient clinic. Patients were randomly divided into three treatment groups： Nexium standard triple therapy （group A, EAC）, Nexium standard quadruple therapy （group B, EBAC）, or Nexium standard triple therapy combined with MSAH （group C; EAC＋MSAH）. Comparisons of H. pylori eradication and symptom amelioration rates were made among the three groups at 2 or 6 weeks after group assignment. RESULTS： There was no difference in H. pylori eradication rates between groups B （EBAC） and C （EAC＋ MSAH） （P = 0.486）, and eradication rates in groups B and C were significantly higher than that in group A （EAC） （P Av, e = 0.001; P AvsC= 0.003）. There was no difference in the total symptom score among the groups before treatment. In all groups, the total symptom scores after treatment （2 or 6 weeks after group assignment） were significantly lower than those before treatment （P 〈 0.001 for all）. However, group C （EAC ＋ MSAH） demonstrated superior total symptom scores and symptom amelioration rates than groups A （EAC） and B （EBAC）. Group B also demonstrated better scores and rates than group A. There was no difference in symptom amelioration rates at 2 and 6 weeks within each group. CONCLUSION： There is no difference between MSAH combined with standard triple therapy and standard quadruple therapy containing bismuth with regard to H. pylori eradication rate. However, MSAH combined with standard triple therapy has a higher symptom amelioration rate and therefore appears to be an idea展开更多
文摘Helicobacter pylori(H. pylori) plays a role in the patho-genesis of gastric cancer. The outcome of the infection depends on environmental factors and bacterial and host characteristics. Gastric carcinogenesis is a multistep process that is reversible in the early phase of mucosal damage, but the exact point of no return has not been identified. Therefore, two main therapeutic strategies could reduce gastric cancer incidence:(1) eradication of the already present infection; and(2) immunization(prior to or during the course of the infection). The success of a gastric cancer prevention strategy depends on timing because the prevention strategy must be introduced before the point of no return in gastric carcinogenesis. Although the exact point of no return has not been identified, infection should be eradicated before severe atrophy of the gastric mucosa develops. Eradication therapy rates remain suboptimal due to increasing H. pylori resistance to antibiotics and patient noncompliance. Vaccination against H. pylori would reduce the cost of eradication therapies and lower gastric cancer incidence. A vaccine against H. pylori is still a research challenge. An effective vaccine should have an adequate route of delivery, appropriate bacterial antigens and effective and safe adjuvants. Future research should focus on the development of rescue eradication therapy protocols until an efficacious vaccine against the bacterium becomes available.
文摘OBJECTIVE： To determine the effectiveness of modified Sanhuang Xiexin Tang （SHXXT） plus additional herbs （MSAH） combined with ＂standard tri- ple therapy＂ for eradication of Helicobacter pylori （H. pylori） and amelioration of related symptoms in comparison with standard triple and standard quadruple therapies. METHODS： From October 2015 to May 2016, we recruited patients with dyspepsia symptoms con- firmed to have H. pylori infection by the ^13C urea breath test in our outpatient clinic. Patients were randomly divided into three treatment groups： Nexium standard triple therapy （group A, EAC）, Nexium standard quadruple therapy （group B, EBAC）, or Nexium standard triple therapy combined with MSAH （group C; EAC＋MSAH）. Comparisons of H. pylori eradication and symptom amelioration rates were made among the three groups at 2 or 6 weeks after group assignment. RESULTS： There was no difference in H. pylori eradication rates between groups B （EBAC） and C （EAC＋ MSAH） （P = 0.486）, and eradication rates in groups B and C were significantly higher than that in group A （EAC） （P Av, e = 0.001; P AvsC= 0.003）. There was no difference in the total symptom score among the groups before treatment. In all groups, the total symptom scores after treatment （2 or 6 weeks after group assignment） were significantly lower than those before treatment （P 〈 0.001 for all）. However, group C （EAC ＋ MSAH） demonstrated superior total symptom scores and symptom amelioration rates than groups A （EAC） and B （EBAC）. Group B also demonstrated better scores and rates than group A. There was no difference in symptom amelioration rates at 2 and 6 weeks within each group. CONCLUSION： There is no difference between MSAH combined with standard triple therapy and standard quadruple therapy containing bismuth with regard to H. pylori eradication rate. However, MSAH combined with standard triple therapy has a higher symptom amelioration rate and therefore appears to be an idea
