摘要
目的探讨不同疗程标准三联疗法复合布拉酵母菌对根除幽门螺杆菌(Helicobacter pylori,H.pylori)疗效的影响及其对治疗中不良反应的改善情况进行系统评价。方法 H.pylori阳性的慢性胃炎、消化性溃疡患者240例,随机分为对照组、短疗程组、中疗程组、长疗程组,每组60例。对照组给予克拉霉素、阿莫西林、潘托拉唑三联治疗14 d,短疗程组、中疗程组、长疗程组在上述标准三联、14 d疗法开始治疗的同时分别加用布拉酵母菌,分别服用2、3、4周,在完成根除H.pylori治疗后第5周进行14C-UBT复查,比较各组H.pylori根除率、药物不良反应发生率,试验结果阴性患者在治疗结束后第3、6、9、12个月复查14C-尿素呼气试验。结果 213按试验设计完成治疗,194例患者按试验设计完成随访。短疗程组H.pylori根除率(73.5%)与对照组(65.9%)比较差异无统计学意义(P>0.05),中疗程组(91.4%)、长疗程组(93.1%)根除率均高于对照组,差异有统计学意义(P<0.05),中疗程组根除率略低于长疗程组,但差异无统计学意义。各疗程组不良反应发生率均较对照组显著降低(P<0.05),但组间比较差异无统计学意义;4组方案中以中等剂量成本-效果比最低(6.56),对照组最高(7.59);各疗程组累积复发率均低于对照组低(P<0.05,P<0.01,P<0.01),各疗程组累积复发率比较差异无统计学意义。结论联用布拉酵母菌能显著提高H.pylori根除率,降低其不良反应,3周疗程为最佳选择治疗周期。数字与后文不符。
Objective To observe the effect of different courses of Saccharomyces boulardii therapy in Helicobacter pylori（ H. pylori） eradication. Methods 240 H. pylori-positive patients with chronic gastritis or peptic ulcer were randomly divided into control group,short-term course group,medium-term course group and long-term course group. The control group underwent standard triple therapy（ Clarithromycin,Amoxicillin and Pantoprazole for 14days）,while the other three groups were additionally given Saccharomyces boulardii for 2,3,and 4 weeks on the basis of standard triple therapy,respectively. The14 C urea breath test was performed 1 week after all the groups finished the treatment; patients with negative result were re-examined by14 C urea breath test 3,6,9 and 12 months after the treatment. The rate of H. pylori eradication and safety were evaluated. Results 213 patients completed the treatment and 194 patients completed follow-up according to the experimental design. There was no difference in the rate of H. pylori eradication between the short-term group and control group（ 73. 5% vs 65. 9%,P〉 0. 05）. The eradication rate was significantly higher in the medium-term and long-term course groups than in the control group（ 91. 4%,93. 1% vs 65. 9%,both P 〈0. 05）,but there was no significant difference between the two treatment groups. The rates of adverse reactions in all the treatment groups were significantly lower than in the control group（ 9. 7% ± 3. 8% vs 5. 1% ± 2. 8%,2. 8% ± 1. 1%,2. 3% ± 0. 9%,P 〈0. 05）,but there was no significant difference among the three treatment groups. The accumulative recurrence rates were significantly lower in all treatment groups than in the control group（ P〉 0. 05,P 〉0. 01,P 〉0. 01）,but there was no significant difference among three treatment groups. The cost-effective ratio of medium-term course group was the lowest（ 6. 56）,while that of the control group was the highest（ 7. 59）. Conclusion Medium-term course of Saccharomyces boulardii treatment combined with triple therapy can improve the rate of H. pylori eradication; three weeks is the best course of treatment.
出处
《中国微生态学杂志》
CAS
CSCD
2015年第1期55-59,共5页
Chinese Journal of Microecology
关键词
布拉酵母菌
幽门螺杆菌
疗程
Saccharomyces boulardii
Helicobacter pylori
Course
作者简介
王丽昆（1977-），女，医学学士，主治医师，从事消化性溃疡及相关流行病学研究工作，Email：763438748@qq．com
通讯作者：余小鸣．Email：f6437323@163．com
