摘要
目的分析双歧杆菌乳杆菌三联活菌辅助治疗幽门螺杆菌(Hp)阳性慢性浅表性胃炎(CSG)患者的临床效果。方法选取2019-11-15-2021-7-15太康县中医院就诊的Hp阳性CSG患者128例,根据性别、年龄、病程等因素组间平衡的原则分组,分为研究组(n=64)和常规组(n=64)。常规组采用雷贝拉唑四联疗法治疗,口服雷贝拉唑钠肠溶胶囊,20 mg/次,3次/d;口服阿莫西林胶囊,0.5 g/次,3次/d;口服克拉霉素胶囊,0.5 g/次,3次/d;口服枸橼酸铋钾胶囊,0.3 g/次,2次/d。研究组在常规组基础上口服双歧杆菌乳杆菌三联活菌,2 g/次,3次/d,2组均连续治疗2周;比较2组疗效、临床症状消失时间、不良反应情况及Hp根除率,治疗前后病情相关指标[白介素-6(IL-6)、白介素-10(IL-10)、白介素-17(IL-17)、白介素-8(IL-8)、转化生长因子β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)],经调查收集、血常规检测收集上述数据,收集的计量资料以x±s表示,存在多个时间点数据采用单因素协方差分析,计数资料用n(%)表示、χ^(2)检验。结果研究组总有效率为96.88%(62/64),高于常规组81.25%(52/64),差异有统计学意义,χ^(2)=8.020,P=0.005;研究组腹部隐痛消失时间为(4.27±0.84)d,短于常规组(7.61±1.25)d,差异有统计学意义,t=17.742,P<0.001;反酸消失时间为(3.96±1.24)d,短于常规组(6.87±1.36)d,差异有统计学意义,t=12.649,P<0.001;嗳气消失时间为(4.16±1.14)d,短于常规组(7.13±1.59)d,差异有统计学意义,t=12.144,P<0.001;上腹不适消失时间为(4.62±1.09)d,短于常规组(7.83±1.39)d,差异有统计学意义,t=14.538,P<0.001;研究组Hp根除率为95.31%(61/64),高于常规组78.13%(50/64),差异有统计学意义,χ^(2)=8.208,P=0.004;研究组不良反应总发生率为1.56%(1/64),低于常规组9.38%(6/64),差异无统计学意义,χ^(2)=2.418,P=0.120;根据治疗前调整后,治疗后与常规组比较,研究组IL-6、IL-17、IL-8、TGF-β1、TNF-α较低,IL-10较高,差异有统计学意义,均P<0.05。结论双歧杆菌乳杆菌三联活菌辅助治疗Hp阳性CSG患者可有效清除体内Hp,改善患者临床症状,还可抑制机体炎症及氧化应激损伤,临床疗效确切。
Objective To analyze the clinical effect of Bifidobacterium Lactobacillus triple viable bacteria in adjuvant treatment of Helicobacter pylori(Hp)positive chronic superficial gastritis(CSG).Methods A total of 128 Hp-positive CSG patients who were treated in Taikang County Traditional Chinese Medicine Hospital from 2019-11-15to 2021-7-15were selected and divided into study group(n=64)and the conventional group(n=64).The routine group was treated with rabeprazole quadruple therapy,oral rabeprazole sodium enteric-coated capsules,20 mg/time,3times/d;oral amoxicillin capsules,0.5g/time,3times/d;oral clathrate Mycin capsules,0.5g/time,3times/d;oral bismuth potassium citrate capsules,0.3 g/time,2times/d.On the basis of the routine group,the study group was given oral administration of Bifidobacterium Lactobacillus triple viable bacteria,2g/time,3times/d,and both groups were treated continuously for 2weeks;The curative effect,clinical symptom disappearance time,adverse reactions and Hperadication rate,disease-related indicators before and after treatment[interleukin-6(IL-6),interleukin-10(IL-10),interleukin-17(IL-17),interleukin-8(IL-8),transforming growth factorβ1(TGF-β1),tumor necrosis factor-α(TNF-α)],oxidative stress indicators[malondialdehyde(MDA),glutathione peroxidation Bio-enzyme(GSH-PX),superoxide dismutase(SOD)]were compared between the two groups.The above data were collected through investigation and blood routine testing.The collected measurement data were expressed as x-±s,and there were multiple time points data using one-factor covariance analysis,the counting data were expressed with n(%),andχ^(2)test was performed.Results The total effective rate of the research group was 96.88%(62/64),which was higher than that of the routine group,81.25%(52/64),with a statistically significant difference,χ^(2)=8.020,P=0.005;the disappearance time of abdominal pain in the research group was(4.27±0.84)d,shorter than that of the routine group(7.61±1.25)d,the difference was statistically significant,t=17.742,P<0.001;the disappearance time of acid reflux was(3.96±1.24)d,shorter than that of the routine group(6.87±1.36)d,the difference was statistically significant,t=12.649,P<0.001;the disappearance time of belching was(4.16±1.14)d,shorter than that of the routine group(7.13±1.59)d,the difference was statistically significant,t=12.144,P<0.001;the disappearance time of epigastric discomfort was(4.62±1.09)d,which was shorter than that of the routine group(7.83±1.39)d,and the difference was statistically significant,t=14.538,P<0.001;the eradication rate of Hpin the study group was 95.31%(61/64),higher than that of the routine group of 78.13%(50/64),the difference was statistically significant,χ^(2)=8.208,P=0.004;the total incidence of adverse reactions in the study group was 1.56%(1/64),lower than that of the routine group of 9.38%(6/64),the difference was not statistically significant,χ^(2)=2.418,P=0.120;According to adjustment before treatment,IL-6,IL-17,IL-8,TGF-β1,TNF-αin the study group were lower,but IL-10was higher,compared with the conventional group after treatment,the difference was statistically significant,all P<0.05.Conclusion Bifidobacterium Lactobacillus triple viable bacteria assignment in the treatment of Hp-positive CSG patients can effectively remove Hpin the body,improve the clinical symptoms of the patients,and also inhibit the body’s inflammation and oxidative stress damage,with definite clinical effect.
作者
王瑞香
李志刚
WANG Rui-xiang;LI Zhi-gang(Department of Internal Medicine,Taikang County Hospital of Traditional Chinese Medicine,Zhoukou 461400,China;Department of Gastroenterology,The Third Affiliated Hospital of Henan University of TraditionalChinese Medicine,Zhengzhou 450000,China)
出处
《社区医学杂志》
CAS
2022年第16期907-911,共5页
Journal Of Community Medicine
关键词
雷贝拉唑
幽门螺杆菌阳性
慢性浅表性胃炎
四联疗法
rabeprazole
helicobacter pylori positive
chronic superficial gastritis
quadruple therapy
