益生菌联合四联疗法治疗老年人群幽门螺杆菌感染的疗效及不良反应发生情况研究

发布时间：2018-07-26 14:36

【摘要】：目的:探讨益生菌联合铋剂四联疗法治疗老年Hp阳性患者的疗效,并观察治疗过程中出现的不良反应,以探讨该方案在老年Hp阳性人群中的疗效及安全性。方法:本实验为前瞻性研究,采用随机对照实验设计。对象为2015年10月至2017年2月就诊于我院的老年Hp阳性患者,符合纳入标准者128例,通过完全随机化的方法分为实验组(64例)、对照组(64例)。实验组给予:枸橼酸铋钾220mg,2次/d,餐前半小时服;泮托拉唑肠溶片40mg,2次/d,餐前半小时服;阿莫西林胶囊1000mg,2次/d,餐后即服;克拉霉素片500mg,2次/d,餐后即服;益生菌(双歧杆菌乳杆菌三联活菌片)4片,2次/d;对照组:不用益生菌,其余治疗方法同实验组。疗程均为10天。治疗结束4周后复查13C或14C尿素呼气试验,结果为阴性者视为Hp根除成功。治疗期间记录患者不良反应发生的情况。结果:128例老年Hp阳性患者中,107例根除成功。意向性分析实验组根除率为84.4%(54/64),对照组根除率为82.8%(53/64),P0.05,两组根除率比较差异无统计学意义;按方案分析实验组根除率为87.1%(54/62),对照组根除率为86.9%(53/61),P0.05,两组根除率比较差异无统计学意义。不良反应发生率实验组低于对照组(23.4%比39.1%),两组的差异有统计学意义(P0.05)。结论:益生菌(双歧杆菌三联活菌片)联合四联疗法治疗老年Hp阳性患者并不能提高Hp的根除率,能降低治疗过程中不良反应的发生率。
[Abstract]:Objective: to investigate the efficacy and safety of probiotics combined with bismuth in the treatment of elderly patients with HP positive. Methods: this experiment was a prospective study and was designed as a randomized controlled trial. From October 2015 to February 2017, 128 elderly patients with HP positive were divided into experimental group (n = 64) and control group (n = 64) by complete randomization. The experimental group was given bismuth potassium citrate 220 mg / d twice a day, half an hour before meal; Pam Tora enteric-coated tablet 40 mg / d, half an hour before meal; amoxicillin capsule 1000mg / 2 / d, after meal; clarithromycin tablet 500mg / g twice / d, after meal; Probiotics (bifidobacterium lactobacillus triple live bacteria tablets) 4 / d; control group: no probiotics, other treatment methods are the same as the experimental group. The course of treatment was 10 days. After 4 weeks of treatment, 13 C or 14 C urea breath test was reexamined and the negative patients were considered as successful HP eradication. Adverse reactions were recorded during treatment. Results 107 out of 128 elderly HP positive patients were successfully eradicated. The eradication rate of the experimental group was 84.4% (54 / 64), and that of the control group was 82.8% (53 / 64) P0.05.The eradication rate of the experimental group was 87.1% (54 / 62) according to the scheme, and the eradication rate of the control group was 86.9% (53 / 61) P 0.05. There was no significant difference in the eradication rate between the two groups. The incidence of adverse reactions in the experimental group was lower than that in the control group (23.4% vs 39.1%), and the difference between the two groups was statistically significant (P0.05). Conclusion: probiotics (bifidobacterium triple live bacteria tablets) combined with tetralogy therapy can not improve the eradication rate of HP and reduce the incidence of adverse reactions in the course of treatment.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R573

【参考文献】