益生菌治疗炎症性肠病与幽门螺杆菌阳性率的相关性分析

摘要

目的 评估应用益生菌治疗炎症性肠病(Inflammatory bowel disease,IBD)与幽门螺杆菌(H.pylory,Hp)阳性率的关系.方法 益生菌疗法采用双歧杆菌乳杆菌三联活菌片,主要包括双歧杆菌1×107 CFU/g,保加利亚乳杆菌1×106 CFU/g和嗜热链球菌1×106 CFU/g.100例IBD患者分为UC(溃疡性结肠炎,Ulcerative colitis)组和CD (克罗恩病,Crohn′s disease)组,每组50例,另有30例健康志愿者为对照组.UC组和CD组每日给予相同剂量三联活菌片(0.5 g/片,4片/次,2次/d),并在3个月内不间断给药.如未出现症状加剧或需要额外治疗,则在用药当日及用药3个月后对临床症状进行评估,并在用药前后同时测定三组Hp阳性率.结果 UC组和CD组各有47例参加本研究,共计94例.用药3个月后,UC组Mayo评分显著下降(4.02±2.18 vs.7.66±1.83,P<0.01),其中有效40例,无效7例,有效率为85.11%,治疗前后炎症指标(CRP、ESR、Hb、Ab)比较,差异有统计学意义(P<0.05).CD组Mayo评分显著下降(4.26±1.78 vs.7.38±1.61,P<0.01),其中有效38例,无效9例,有效率为80.85%,治疗前后炎症指标(CRP、ESR、Hb、Ab)比较,差异有统计学意义(P<0.05).应用益生菌治疗后,UC组和CD组的Hp阳性率均显著升高(80.85% vs.57.45%,57.45% vs.36.17%,P<0.05),但治疗后两组的Hp阳性率均低于对照组(80.85% vs.90%,57.45% vs.90%).结论 对于不同类型的炎症性肠病患者,益生菌可以改善炎症指标并有效缓解临床症状,但幽门螺杆菌阳性率与益生菌疗效呈负相关.%Objective To evaluate the relationship between the probiotics in the treatment of inflammatory bowel disease (IBD) and the positive rate of helicobacter pylori (H.pylory,Hp).Methods Live combined bifidobacterium and lactobacillus tablets,including bifidobacterium 1×107 CFU/g,lactobacillus bulgaricus 1×106 CFU/g and streptococcus thermophilus 1×106 CFU/g,were used in the probiotic therapy.We collected 100 IBD patients (including 50 with ulcerative colitis and 50 with Crohn′s disease) and 30 healthy volunteers.UC group and CD group were daily given the same dose of Golden bifid (0.5 g a piece,4 pieces a time,twice daily) for continuously 3 months.If the symptoms did not appear to aggravate or require additional treatment,the clinical symptoms were assessed on the day of medication and 3 months after treatment,and the positive rates of Hp in the three groups were measured before and after treatment.Results In UC group and CD group,47 patients in each group participated in the experiment,and a total of 94 patients completed the experiment.After 3 months of treatment,Mayo scores in UC group and CD group were significantly decreased (4.02±2.18 vs.7.66±1.83,4.26±1.78 vs.7.38±1.61,P<0.01);the number of effective and invalid cases was 40 and 7,38 and 9;the effective rate was 85.11% and 80.85%.There were significant differences in inflammatory markers (CRP,ESR,Hb and Ab) before and after treatment (P<0.05).After treatment with probiotics,the positive rate of Hp was significantly higher in UC group (80.85% vs.57.45%,P<0.05) and CD group (57.45% vs.36.17%,P<0.05),but both of positive rates were lower than that of control group (80.85% vs.90%,57.45% vs.90%).Conclusion Probiotics can improve the inflammation markers and alleviate the clinical symptoms for patients with different types of inflammatory bowel disease,but the Hp positive rate is negatively correlated with the effect of probiotics.