四联疗法联合布拉氏酵母菌散治疗幽门螺杆菌感染125例

摘要

Objective To discuss whether Saccharomyces boulardii sachets can improve the eradication rate and reduce some untoward effects of gastrointestinal tract when adding in the Helicobacter pylori (Hp) standard quadruple therapy.Methods 249 cases infected with Hp were randomly divided into control group(124 cases) and treatment group (125 cases).The control group was treated with standard quadruple therapy:colloidal bismuth pectin capsules,100 mg,tid,po;furazolidone tablets,0.1 g,bid,po;amoxil capsule,1 g,bid,po;rabeprazole sodium enteric-coated capsules,20 mg,qd,po.The treatment group was treated with Saccharomyces boulardii sachets(0.25 g,bid,po)besides.Both groups were treated for 4 weeks.Evaluate the effect of Hp eradication rate by using the method of intent of treatment (ITT) analysis and consistent scenario set (PP)analysis.Results According to the ITT analysis,the eradication rate of control group was 89.52%,and that of treatment group was 96.00%.According to the PP analysis,the eradication rate of control group was 90.00%,and the rate of treatment group was 97.39%.Both analysis results showed the eradication rate of Hp in treatment group was significantly higher than control group(P<0.05).As for reducing the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra,control group was obviously lower than treatment group (P<0.05).Conclusion Compared with standard quadruple therapy only,adding Saccharomyces boulardii sachets can significantly improve the eradication rate of Hp and obviously reduce the untoward effects such as nausea,inappetence,diarrhea,astriction and erythra.It is worth to be generalized and applied in clinical practice.%目的 探讨标准四联疗法加入布拉氏酵母菌散治疗幽门螺杆菌(Hp) 感染的临床疗效.方法 Hp感染患者249例,按照随机数字表法分为对照组(n=124)和治疗组(n=125).对照组采用标准四联疗法:胶体果胶铋胶囊100 mg,tid,po;呋喃唑酮片 0.1 g,bid,po;阿莫西林胶囊 1 g,bid,po;雷贝拉唑钠肠溶胶囊20 mg,qd,po.治疗组在同时服用对照组药物基础上加服布拉氏酵母菌散0.25 g,bid,po.两组患者均连续治疗2周.采用意向性治疗(ITT)分析及符合方案集(PP)分析两种方法综合评价两组用药对Hp根除率的影响.结果 ITT分析结果表明,对照组和治疗组Hp感染根除率分别为89.52%,96.00%;PP分析结果表明,对照组和治疗组Hp感染根除率分别为90.00%,97.39%.两种分析结果均表明,治疗组比对照组Hp根除率均显著提高(均P<0.05).治疗组恶心、食欲不振、腹泻、便秘、皮疹等不良反应发生率均明显低于对照组(均P<0.05或P<0.01).结论 四联疗法联合布拉氏酵母菌散能够提高Hp根除率,减少恶心、食欲不振、腹泻、便秘、皮疹等不良反应,值得临床推广应用.