标准三联疗法联合益生菌治疗幽门螺杆菌相关慢性胃炎的疗效

摘要

目的探讨标准三联疗法联合益生菌治疗幽门螺杆菌(Hp)相关慢性胃炎的疗效.方法将130例Hp阳性的慢性胃炎患者按照随机数字表分为三联组(65例)和联合组(65例).三联组给予标准三联疗法(阿莫西林+克拉霉素+雷贝拉唑,联合组给予标准三联疗法+益生菌,疗程均为2周.评估患者的临床症状改善情况,结束4周复查Hp并随访1年,比较2组Hp根除率、复发率及不良反应.结果治疗1周、2周后,2组临床症状评分均显著降低,联合组临床症状评分明显低于三联组(P<0.05);治疗2周后,联合组的总有效率为94%,高于其治疗1周时的77%,也显著高于三联组82%(P<0.05);联合组Hp根除率、1年复发率分别为86%、12%,三联组分别为71%、28%,差异均有统计学意义(P<0.05);联合组不良反应发生率分别为15%,显著低于三联组32%(P<0.05).结论标准三联疗法联合益生菌治疗Hp相关慢性胃炎,可明显提高Hp的根治率,减轻胃黏膜炎症程度,降低复发率及胃肠道的不良反应.%Objective To explore clinical effectiveness of probiotics combined with standard triple therapy in helicobacter pylori(Hp) infection associated chronic gastritis .Methods A total of 130 chronic gastritis patients with Hp positive were randomly divided into two groups according to random number table .Triple group was treated with rabeprazole+clarithromycin+amoxicillin ,and combined group was given probiotics additionally .Af-ter 2 weeks of treatment ,the improvement of clinical symptoms were evaluated .Four weeks after the treatment , Hp infection was rechecked and followed up for 1 year to assess the Hp eradication rate ,recurrence rate and side effects during treatment .Results After treatment for 1 and 2 weeks ,the scores of clinical symptoms were all re-duced ,and the scores in combined group were significantly lower than those in triple group(P< 0.05) .After treatment for 2 weeks ,the total effective rate in combined group was 94% ,which was significantly higher than 77% of treatment for 1 weeks and 82% in triple group (P<0.05) .There was significant difference on Hp eradica-tion rate and 1-year recurrence rate between combined group and triple group (86% vs 71% ,12% vs 28% ) (P<0.05) .The rate of side effects in combined group and triple group was 15% and 32% ,it was statistically different between the two groups (P<0.05) .Conclusion Combined use of probiotics on the basis of standard triple therapy for treating chronic gastritis patients with Hp infection can obviously increase the Hp eradication rate ,improve gastric mucosal inflammation and reduce the recurrence rate and gastrointestinal side effects .